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INTERNATIONAL NARCOTICS CONTROL BOARD
Report
2023
EMBARGO
Observe release date:
Not to be published or broadcast before
5 March 2024, at 1100 hours (CET)
CAUTION
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Reports published by the International Narcotics Control Board for 2023
The
Report of the International Narcotics Control Board for 2023
(E/INCB/2023/1) is supplemented
by the following reports:
Narcotic Drugs: Estimated World Requirements for 2024 — Statistics for 2022
(E/INCB/2023/2)
Psychotropic Substances: Statistics for 2022 — Assessments of Annual Medical and Scientific
Requirements for Substances in Schedules II, III and IV of the Convention on Psychotropic Sub-
stances of 1971 for 2024
(E/INCB/2023/3)
Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psy-
chotropic Substances: Report of the International Narcotics Control Board for 2023 on the Imple-
mentation of Article 12 of the United Nations Convention against Illicit Traffic in Narcotic Drugs
and Psychotropic Substances of 1988
(E/INCB/2023/4)
The updated lists of substances under international control, comprising narcotic drugs, psycho­
tropic substances and substances frequently used in the illicit manufacture of narcotic drugs and
psychotropic substances, are contained in the latest editions of the annexes to the statistical forms
(“Yellow List”, “Green List” and “Red List”), which are also issued by the Board.
Contacting the International Narcotics Control Board
The secretariat of the Board may be reached at the following address:
Vienna International Centre
Room E­1339
P.O. Box 500
1400 Vienna
Austria
In addition, the following may be used to contact the secretariat:
Telephone:
Fax:
Email:
(+43­1) 26060
(+43­1) 26060­5867 or 26060­5868
[email protected]
The text of the present report is also available on the website of the Board (www.incb.org).
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INTERNATIONAL NARCOTICS CONTROL BOARD
Report
of the International Narcotics Control Board
for 2023
UNITED NATIONS
Vienna, 2024
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E/INCB/2023/1
UNITED NATIONS PUBLICATION
Sales no.: E.24.XI.2
ISBN: 9789210030526
eISBN: 9789213587966
ISSN: 0257-3717
Online ISSN: 1564-8729
© United Nations: International Narcotics Control Board, January 2024. All rights reserved worldwide.
Publishing production: English, Publishing and Library Section, United Nations Office at Vienna.
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Foreword
The members of the International Narcotics Control Board (INCB) were deeply saddened by the pass-
ing of Mr. Bernard Leroy in February 2023. A member of the Board since 2015, Mr. Leroy served as
Rapporteur of the Board in 2015, 2018 and 2020, and also served in various years as a member of the
Board’s Standing Committee on Estimates and the Board’s Committee on Finance and Administration.
Mr. Leroy conducted missions to Bolivia (Plurinational State of), Egypt, Jamaica, Luxembourg and
Mauritius on behalf of the Board. He was renowned for his legal expertise and extensive experience at
the national and international levels, as well as in civil society, and the Board pays tribute to his valuable
contribution to the functioning of the international drug control system.
The year was characterized by emergencies resulting from natural disasters, climate change and conflict,
which resulted in acute humanitarian needs – including for medicines containing internationally con-
trolled substances. INCB has been calling upon Governments to ensure the unimpeded international
availability of these medicines and raising awareness of the possibility of using simplified control pro-
cedures in such situations.
Chapter II, part B, of this annual report expands on this matter and presents an analysis of the global
availability of narcotic drugs and psychotropic substances for medical and scientific purposes. Data
reported to INCB confirm persistent disparities between regions in the consumption of opioid analgesics
such as morphine for pain treatment and anaesthesia, with use concentrated in Western Europe, North
America, Australia and New Zealand. Our analysis indicates that this disparity is due to countries not
accurately estimating their medical requirements for these substances, many of which are considered
by WHO to be essential medicines. Levels of consumption of affordable morphine in regions other than
Europe and North America are also insufficient to adequately address medical needs.
To better guide Governments, international and regional organizations and civil society in their efforts
to improve the situation, the Board has introduced for each regional section a summary on availability
of controlled substances for licit purposes and related reporting. INCB is committed to supporting
Member States in improving the availability of controlled substances for medical, scientific and indus-
trial purposes and to this end was pleased to conduct training in 2023 for Central Asian and South
American countries through the INCB Learning programme. We hope to count on increased sup-
port and participation of Member States to ensure that this capacity-building programme, including
e-learning resources, can continue to benefit States in improving treaty implementation and availability
of controlled substances for licit purposes.
Regarding the illicit supply of drugs, we have witnessed a dramatic decline in illicit opium poppy cul-
tivation and heroin production in Afghanistan. As affected farmers may not have alternative sources
of income, alternative livelihoods need to be secured. Governments and the international community
will need to closely monitor developments and the response of illicit markets globally, particularly with
regard to the provision of evidence-based treatment and rehabilitation services and the serious threat
posed to public health by potential substitution with highly potent synthetic opioids.
Trafficking in synthetic drugs and their precursors represents a growing threat to public health glob-
ally. During the 138th session of INCB, the Board met with Member States to discuss operational sup-
port provided within the frameworks of the INCB precursor control and Global Rapid Interdiction of
Dangerous Substances (GRIDS) programmes, details of which are provided in the present annual report
and the 2023 report on precursors. To address this threat, new initiatives have been put in place by
INCB to support Governments in strengthening partnerships with chemical industry, mapping national
chemical industry sectors, preventing diversion and misuse of specialized equipment used in illicit drug
manufacture, and supporting public-private partnerships to prevent exploitation of Internet-based and
postal/courier services for trafficking in non-medical synthetic opioids and new psychoactive substances.
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The role of the Internet, including social media, in drug trafficking and use, is explored in the thematic
chapter of the report. The chapter highlights both the challenges and opportunities faced by the inter-
national community in the Internet era, focusing on online drug trafficking and difficulties faced by law
enforcement authorities due to encryption technologies and jurisdictional issues. The increasing use of
social media platforms to market illicit drugs, including to children and adolescents, is highlighted, as
are opportunities presented by these platforms, such as for prevention of non-medical use of drugs and
awareness-raising. The chapter also sets out how legitimate e-commerce platforms are being exploited
for drug trafficking and presents efforts being taken to foster cooperation between Governments and
online industries. The Board held consultations with civil society on this topic during its 137th session
in May 2023. The chapter concludes with a number of areas for action by Governments, including
engagement with the private sector and participation in INCB operational activities. These activities
are enabling law enforcement and customs authorities worldwide to share information in real time to
prevent highly potent and potentially fatal substances from reaching members of the public.
Safeguarding health and welfare is at the heart of the three international drug control conventions. This
report also reviews the functioning of the international drug control system, including INCB support
to Member States to improve treaty implementation and promote health and well-being.
The past year saw the resumption of INCB country missions, with the first mission since the COVID-19
pandemic-related travel restrictions taking place in December 2022. We were pleased to work with the
Governments of Canada, Cyprus, Kyrgyzstan, the United States and Uruguay, and also to meet with
representatives of civil society in those countries. We look forward to continuing this dialogue with
Member States, particularly in the context of the Commission on Narcotic Drugs mid-term review of
implementation of drug policy commitments and in progressing the Sustainable Development Goals.
At the mid-point for the implementation of the Goals and the 2030 Agenda, it is heartbreaking to see
how little progress has been made towards Sustainable Development Goal 3 on good health and well-
being. I urge Governments and international and regional organizations to apply the recommendations
set out in this report, and encourage civil society organizations to be cognizant of these recommenda-
tions in planning their work. Each and every member of our global society has the right to the highest
attainable standard of health. The evidence-based tools exist. With the political will of Governments
and the targeted support of the international community and civil society, the health and well-being
of all can be a reality.
Jallal Toufiq
President
International Narcotics Control Board
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Contents
Page
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Explanatory notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Chapter
I . The role of the Internet, including social media, in drug trafficking and use . . . . . . . . . . . . . . . . . . . . . . .
A . Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B . Opportunities offered by the Internet to prevent non-medical drug use . . . . . . . . . . . . . . . . . . . . . . . .
C . Challenges posed by the Internet to drug control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D . INCB support to Governments to prevent exploitation of the Internet . . . . . . . . . . . . . . . . . . . . . . . . .
E . Law enforcement, public health and community responses to address the non-medical
use of drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F . Conclusions and recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
II . Functioning of the international drug control  system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A . Promoting the consistent application of the international drug control treaties . . . . . . . . . . . . . . . . . .
B . Ensuring the availability of internationally controlled substances for medical and
scientific purposes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C . Overall treaty compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D . Action taken by the Board to ensure the implementation of the international
drug control treaties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
III . Analysis of the world situation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A . Global issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B . Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C . Americas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Central America and the Caribbean . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
North America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
South America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D . Asia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
East and South-East Asia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
1
2
3
12
13
14
17
17
24
31
41
51
51
62
70
70
76
85
95
95
iii
vii
South Asia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
West Asia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
E . Europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
F . Oceania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
IV . Recommendations to Governments, the United Nations and other relevant international and
national organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Annexes
I . Regional and subregional groupings used in  the  report of the International Narcotics
Control Board for 2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
II Current membership of the International Narcotics Control Board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
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Explanatory notes
Data reported later than 1 November 2023 could not be taken into consideration in the preparation
of this report.
The defined daily doses for statistical purposes (S-DDD) are used by INCB as a technical unit of measure-
ment for the purpose of statistical analysis and are not a recommended prescription dose. This defini-
tion, which is not free of a certain degree of arbitrariness, recognizes that there are no internationally
agreed standard dosages for narcotic drugs and psychotropic substances, that they are used in certain
countries for different treatments or in accordance with different medical practices, and that therefore
amounts expressed in S-DDD units should be considered an approximate measure used for ranking
consumption in different countries. For narcotic drugs, levels of consumption, expressed in S-DDD
per million inhabitants per day, are calculated by using the following formula: the annual consumption
reported by a country or a territory, excluding the amount utilized for the manufacture of preparations
listed in Schedule III of the 1961 Convention, is divided by the defined daily dose established for each
substance, then divided by the population, in millions, and then divided by 365 days. The result obtained
is the S-DDD value for that particular drug for that country or territory.
The S-DDD by region value is calculated by adding up the consumption amount (excluding the amounts
utilized for the manufacture of preparations listed in Schedule III), dividing by the defined daily dose for
each substance, and then dividing, successively, by the total population of the countries in that region
that have reported to the Board, expressed in millions, and then dividing by 365 days.
The global S-DDD value for each substance reflected in some diagrams is calculated by adding the S-DDD
separately calculated for each individual country or territory to obtain a value which represents the sum
of all S-DDDs of consumption for each substance.
Countries and areas are referred to by the names that were in official use at the time the relevant data
were collected.
References to dollars ($) are to United States dollars, unless otherwise stated.
The following abbreviations have been used in this report:
AIRCOP
ASEAN
CARICC
CBD
CICAD
COPOLAD
CSTO
ELITE
EMCDDA
Europol
FARC-EP
GHB
GRIDS Programme
ha
Airport Communication Programme
Association of Southeast Asian Nations
Central Asian Regional Information and Coordination Centre
cannabidiol
Inter-American Drug Abuse Control Commission
Cooperation Programme between Latin America, the Caribbean and the
European Union on Drugs Policies
Collective Security Treaty Organization
eLearning Individual Training Environment
European Monitoring Centre for Drugs and Drug Addiction
European Union Agency for Law Enforcement Cooperation
Revolutionary Armed Forces of Colombia – People’s Army
gamma-hydroxybutyrate
Global Rapid Interdiction of Dangerous Substances Programme
hectare(s)
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I2ES
IDS
INCB
INTERPOL
IONICS
LSD
MDMA
MERCOSUR
OAS
OHCHR
OPIOIDS project
PAHO
PEN Online
PICS
SENAD
S-DDD
THC
UNAIDS
UNAMA
UNDP
UNICEF
UNODC
UPU
WCO
WHO
International Import and Export Authorization System
INCB International Drug Control System
International Narcotics Control Board
International Criminal Police Organization
Project Ion Incident Communication System
lysergic acid diethylamide
3,4-methylenedioxymethamphetamine
Southern Common Market
Organization of American States
Office of the United Nations High Commissioner for Human Rights
global Operational Partnerships to Interdict Opioids’ Illicit Distribution and
Sales project
Pan American Health Organization
Pre-Export Notification Online system
Precursors Incident Communication System
National Secretariat for Drug Policy of Brazil
defined daily dose for statistical purposes
tetrahydrocannabinol
Joint United Nations Programme on HIV/AIDS
United Nations Assistance Mission in Afghanistan
United Nations Development Programme
United Nations Children’s Fund
United Nations Office on Drugs and Crime
Universal Postal Union
World Customs Organization
World Health Organization
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Chapter I.
The role of the Internet, including social media,
in drug trafficking and use
The international community faces both challenges and
opportunities for drug control, prevention and treatment in
the era of the Internet, and the present chapter explores the
intersection of the international drug control treaties and
the challenges posed by the Internet, with a specific focus
on the evolving landscape of online drug trafficking. Law
enforcement authorities encounter difficulties in monitor-
ing and prosecuting online drug activities due to the use
of encryption technologies and jurisdictional issues that
require global collaborative efforts. Social media is increas-
ingly used as a local marketplace for illicit drugs, raising
concerns about increased accessibility for children and ado-
lescents. At the same time, these platforms offer opportuni-
ties to prevent non-medical drug use and raise awareness
about the harms of such use by enabling communication
with and between people who use drugs, coordinate strate-
gic community responses and allow drug-checking services
to support public health initiatives. This chapter also dis-
cusses the misuse of legitimate e-commerce platforms for
drug trafficking, emphasizing efforts to foster cooperation
between Governments and online industries. Criminal
groups exploit online platforms for the trafficking of nar-
cotic drugs, psychotropic substances, precursor chemi-
cals and other new psychoactive substances. The online
presence of fentanyl and synthetic opioids raises serious
concerns due to their high potency and the risk of overdose
deaths. INCB initiatives to prevent the exploitation of the
Internet for drug trafficking include Operation Acronym, the
GRIDS Programme and tools such as IONICS for real-time
information exchange. INCB notes that there is a need to
further develop public-private partnerships and stresses
the need for international cooperation and enhanced leg-
islation to address evolving challenges in Internet-driven
drug trafficking.
A. Introduction
1. The international community adopted the Single
Convention on Narcotic Drugs of 1961 and the Convention
on Psychotropic Substances of 1971 prior to the advent of
the Internet, and the United Nations Convention against
Illicit Traffic in Narcotic Drugs and Psychotropic Substances
of 1988 shortly before the major changes in information
and communication technologies became global in reach.
These conventions are the cornerstone of the international
drug control system and continue to guide concerted actions
aimed at safeguarding health and welfare. Signatory coun-
tries are obliged to limit exclusively to medical and scien-
tific purposes the production, manufacture, export, import,
distribution of, trade in, use and possession of drugs, while
ensuring their availability for such purposes.
1
Legislative,
regulatory and policy measures implemented to achieve
these aims must be proportionate, humane and grounded
in respect for human rights.
2
The Internet has proved to offer
both opportunities to support the aims of the conventions
and to undermine them, as it enables communication that
facilitates trade and trafficking in and use of narcotic drugs,
psychotropic substances and precursor chemicals.
3
2. The international cooperation fostered by the three
United Nations drug control treaties continues to prevent
1
2
3
Single Convention on Narcotic Drugs of 1961, art. 4, para. 1 (c).
E/INCB/2022/4.
World Drug Report 2022
(United Nations publication, 2022).
1
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2
INCB REPORT 2023
diversion from licit international trade in narcotic drugs,
psychotropic substances and precursor chemicals. However,
criminals have also adapted to the new informational and
technological environment. The growth in online drug
trafficking follows the broader trend in Internet use and
Internet-facilitated trade. The role of the Internet in drug
trafficking and in the sourcing of precursor chemicals and
equipment for illicit drug manufacture has evolved but
has not yet dramatically changed drug supply chains. The
share of illicit transactions that occur online is still grow-
ing, constituting every year a larger share of the global illicit
drug market, which is valued at between $200 billion and
$600 billion.
4
There is considerable potential for Internet-
facilitated drug markets to further expand as the technologi-
cal components continue to evolve and larger shares of the
global population use social media.
5
3. As early as 2000, the Commission on Narcotic Drugs, in
its resolution 43/8, resolved to curtail the availability of con-
trolled pharmaceuticals and precursor chemicals for illicit
purposes through the misuse of the World Wide Web.
6
In
2009, the International Narcotics Control Board (INCB)
published the
Guidelines for Governments on Preventing the
Illegal Sale of Internationally Controlled Substances through
the Internet.
7
In chapter I of the annual report of the Board
for 2015, entitled “The health and welfare of mankind: chal-
lenges and opportunities for the international control of
drugs”, the emerging problem of the use of the Internet for
drug trafficking and use was addressed. In the conclusions
and recommendations of that thematic chapter, the need
was underlined for States to expand the range of interven-
tions to cope with new psychoactive substances and the
marketing technologies used to promote and facilitate the
non-medical use of drugs through the use of the Internet
and social media.
8
Moreover, the INCB annual report for
2021 addressed, as a global issue, the use of social media in
the promotion of the non-medical use of drugs.
9
World Drug Report 2005,
vol. 1,
Analysis
(United Nations pub-
lication, 2005); and Harry R. Sumnall, “The harm reduction impact of
cryptomarkets: inequality and opportunity”,
Addiction,
vol. 113, No. 5
(2018), pp. 801–802.
4
4. Currently, the urgent macro-level challenges to inter-
national drug control are the misuse, diversion from
domestic trade and evolution of designer and pre-precursor
chemicals and new psychoactive substances, including non-
medical synthetic opioids, that are not under international
control. At the micro level, the Internet and especially social
media, in combination with encryption technologies, have
increased the availability of drugs on the illicit market and
made it more difficult for law enforcement authorities to
prevent drug trafficking.
5. The international drug control treaties obligate States
parties to take steps to prevent the diversion of controlled
substances into illicit channels while also facilitating their
availability for legitimate medical and scientific purposes. In
a globalized market, reducing illicit supply involves interna-
tional cooperation, even at the production stage. The iden-
tification of suspicious online transactions is challenging
because they are hidden within legitimate trade. To apply
the international drug control treaties, States parties should
implement comprehensive and balanced approaches to reg-
ulate new online marketplaces.
10
This requires an appropri-
ate focus on reducing illicit supply and demand for drugs,
promoting research and sharing knowledge.
B. Opportunities offered by the
Internet to prevent non-medical
drug use
6. Telemedicine and Internet pharmacies illustrate the
duality of challenges and opportunities. They both hold
great potential for improving access to health care but at
the same time enable illegitimate actors to hide among
legitimate providers. Telemedicine is a fast-growing health-
care delivery option.
11
Using the Internet, physicians have
the ability to issue prescriptions online, but several studies
suggest a correlation between telemedicine and overpre-
scription.
12
For consumers, Internet pharmacies offer lower
Judith Aldridge, Alex Stevens and Monica Barratt, “Harms, ben-
efits and the policing of cryptomarkets: a response to commentaries”,
Addiction,
vol. 113, No. 5 (2018), pp. 802–804; Judith Aldridge, Alex
Stevens and Monica Barratt, “Will growth in cryptomarket drug buying
increase the harms of illicit drugs?”,
Addiction,
vol. 113, No. 5 (2018),
pp. 789–796; European Monitoring Centre for Drugs and Drug Addic-
tion (EMCDDA) and European Union Agency for Law Enforcement
Cooperation (Europol),
EU Drug Markets: Impact of COVID-19
(Luxem-
bourg, Publications Office of the European Union, 2020); and
World Drug
Report 2023,
booklet 2,
Contemporary Issues on Drugs
(United Nations
publication, 2023), chap. 7.
5
6
7
8
9
10
11
E/INCB/2022/1.
E/INCB/2022/4.
United Nations publication, Sales No. E.09.XI.6.
See E/INCB/2015/1, chap. I.
E/INCB/2021/1.
Laura Hoffman, “Shedding light on telemedicine and online pre-
scribing: the need to balance access to health care and quality of care”,
American Journal of Law and Medicine,
vol. 46, Nos. 2 and 3 (July 2020),
pp. 237–251; and Kostas Mouratidis and Apostolos Papagiannakis,
“COVID-19, Internet, and mobility: the rise of telework, telehealth,
e-learning, and e-shopping”,
Sustainable Cities and Society,
vol. 74 (2021),
p. 103182.
Tim K. Mackey, Bryan A. Liang and Steffanie A. Strathdee, “Digi-
tal social media, youth, and nonmedical use of prescription drugs: the
need for reform”,
Journal of Medical Internet Research,
vol. 15, No. 7 (July
2013), pp. e143.
12
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ChAPTER I. ThE ROLE Of ThE INTERNET, INCLuDING SOCIAL mEDIA, IN DRuG TRAffICkING AND uSE
3
costs, convenience and privacy, while businesses can save
on expenses and increase their competitiveness.
13
7. For the purposes of providing treatment, rehabilita-
tion, aftercare and social reintegration services for people
with drug use disorders, telemedicine represents a valuable
additional resource for reaching patients,
14
and the online
delivery of services related to drug treatment holds great
potential.
15
There are several online discussion forums dedi-
cated to drug-related topics. These discussions sometimes
relate to practical logistical issues about procuring drugs
illicitly, such as naming fraudulent sellers and describing
online security measures,
16
but people also discuss the
inherent risks of drug use.
17
This information can be highly
localized and includes warnings about adulterated drugs
encountered.
18
While this knowledge-sharing is a positive
element, it is unknown if it is associated with significant
reductions in aggregate health-related costs, as the persons
reached in this way are seldom among the most vulnerable
people who use drugs.
19
8. National health authorities can improve their use of
social media platforms to reach youth with drug use pre-
vention advice and health warnings and provide informa-
tion on where and how to seek help for problematic drug
use. INCB recognizes the efforts of some Governments and
international organizations to make use of the Internet to
prevent drug use and improve drug control at the national
and international levels.
exploiting social media and other online platforms to
advertise their products. Online communication between
sellers and potential buyers is discreet and even encrypted
and blends in with the massive stream of legitimate
messages and e-commerce activities. The sheer scale of
communications on these platforms makes it exceedingly
difficult for regulatory authorities to monitor, even if the
communications leave digital traces. It is complicated to take
legal action and prosecute trafficking offences conducted
online. There are jurisdictional issues owing to the global
reach of Internet-facilitated drug trafficking, and offenders
can move their activities to territories with less intensive law
enforcement action and lighter criminal sanctions or base
themselves in countries where they can evade extradition.
10. New encryption technologies and innovations such
as virtual private networks to hide users’ Internet Protocol
address, combined with conventional free speech protec-
tion, the right to anonymity and the use of slang and emojis,
leaves law enforcement authorities with a daunting task.
While it is difficult to investigate and attribute criminal
responsibility to individuals, drug traffickers only have to
make one mistake before law enforcement authorities can
establish their identity.
20
11. Recently, organized criminal groups in Europe have
exploited Internet-based technologies to traffic drugs, using
modified smartphones, “cryptophones” or “PGP” phones
running EncroChat and similar software. They believed that
they were communicating confidentially, but law enforce-
ment authorities managed to decrypt their conversations
and took down several high-value targets beginning in 2021.
In France alone, the National Gendarmerie collected over
120 million text messages from 60,000 mobile phones, with
data tracing back to more than 100 countries.
21
The ensuing
criminal cases in several European countries resulted in an
unprecedented number of convictions for large-scale drug
trafficking, homicides and weapons offences.
22
The duality
of encrypted online communications is that they are safe
for criminals until they are no longer safe.
C. Challenges posed by the Internet
to drug control
9. The Internet connects sellers and potential buyers of
both licit and illicit commodities across the globe. Drug
traffickers can reach a large international audience by
Sia Chong Hock, Mervyn Ming Xuan Lee and Lai Wah Chan,
“Regulating online pharmacies and medicinal product e-commerce”,
Pharmaceutical Engineering,
vol. 39, No. 6 (November/December 2019).
13
14
15
16
E/INCB/2022/1.
World Drug Report 2022.
James Martin, Jack Cunliffe and Rasmus Munksgaard,
Cryptomar-
kets: A Research Companion
(Bingley, United Kingdom, Emerald Group
Publishing, 2019).
Angus Bancroft, “Responsible use to responsible harm: illicit drug
use and peer harm reduction in a darknet cryptomarket”,
Health, Risk and
Society,
vol. 19, Nos. 7 and 8 (December 2017), pp. 336–350.
17
United States, Department of Justice, “Administrators of Deep-
DotWeb indicted for money-laundering conspiracy, relating to kick-
backs for sales of fentanyl, heroin and other illegal goods on the
darknet”, press release, 8 May 2019; and Europol, “Bitzlato: senior man-
agement arrested”, press release, 23 January 2023.
20
Jan-Jaap Oerlemans and D.A.G van Toor, “Legal aspects of the
EncroChat operation: a human rights perspective”,
European Journal of
Crime, Criminal Law and Criminal Justice,
vol. 30, Nos. 3 and 4 (2022),
pp. 309–328.
21
Aldridge, Stevens and Barratt, “Will growth in cryptomarket
drug buying increase”.
18
19
Sumnall, “The harm reduction impact of cryptomarkets”.
Europol, “DeepDotWeb shut down: administrators suspected of
receiving millions of kickbacks from illegal dark web proceeds”, press
release, 8 May 2019; and Europol, “Double blow to dark web market-
places”, press release, 3 May 2019.
22
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4
INCB REPORT 2023
Cryptophones are specially designed smartphones with
enhanced encryption methods, protecting all communi-
cation systems. While their hardware is similar to regular
mobile phones, the key distinction lies in advanced encryp-
tion software. These devices prioritize security and privacy,
offering features such as encrypted calls and texts, secure
boot, bootloader protection, and hardware-level security
measures to prevent tampering.
12. Access to the Internet varies from region to region and
within countries, but its importance is rising everywhere,
and the trend is set to continue. In Western countries, young
people typically acquire their first mobile phone between the
ages of 7 and 10, and a growing share of adolescents’ social
activities occur online.
23
In the United States of America,
nearly 40 per cent of children as young as 8 to 12 years of
age use social media, and teenagers spend several hours
per day on social media, an average of 3.5 hours accord-
ing to one survey.
24
Almost half of teenagers in the United
States say that they use the Internet “almost constantly” –
double the number compared with only eight years ago.
25
Accompanying this increase among children in time spent
online, however, there has been a concurrent decline in
risk-taking behaviour in adolescents, including substance
use and physical fighting. Less time spent in unstructured
socializing with peers in public results in fewer opportuni-
ties and temptations for conventional offending.
26
13. Seen over a period of 30 years, the evolving use of the
Internet shows how drug distributors adapt their behaviours
to reduce their risk of being apprehended.
27
Initially, this
entailed a shift away from open-air, street-level marketplaces
and towards indoor sales. Online distribution is a continu-
ation of the leveraging by offenders of technology.
28
It is
Alex McCord, Philip Birch and Lewis A. Bizo, “Digital displace-
ment of youth offending: scoping and understanding the issue”,
Journal
of Criminological Research, Policy and Practice,
vol. 8, No. 4 (June 2022),
pp. 243–259.
23
not a uniform trend towards discretion. Some segments of
the online trade are “going dark” by utilizing decentralized
software and encrypted communications, while others are
increasingly brazen and use conventional social media. So
far, the available research on these issues has been concen-
trated on the Global North, Australia and New Zealand.
1.
Cryptomarkets: moving towards
wholesale
14. Cryptomarkets are online darknet marketplaces
located on the Deep Web. The Deep Web has content that is
not indexed by search engines, for example, online banking
and webmail, and it accounts for 96 per cent of all Internet
traffic. Darknet markets are accessible only with specific
software, such as the anonymity proxy network the Onion
Router (Tor), and they use PGP encryption to mask emails
and cryptocurrencies for payment.
29
Cryptomarkets first
came to the public’s attention in 2013 with the arrest of the
administrator of Silk Road 2.0. Since then, law enforcement
agencies in the United States and the European Union have
arrested dozens of administrators and indicted them for
narcotics trafficking, money-laundering and conspiracy.
30
Tor is a peer-to-peer overlay network that allows people to
browse the Internet anonymously. It uses multiple layers
of encryption to conceal both the source and destination
of information. Tor directs internet traffic through a global
volunteer network of over 7,000 relays, making it difficult to
trace a user's activity. This free and open-source software
protects personal privacy by hiding a user's location and
usage from network surveillance or traffic analysis, ensuring
IP address anonymity through Tor exit nodes.
United States, Department of Health and Human Services, “Sur-
geon General issues new advisory about effects social media use has on
youth mental health”, press release, 23 May 2023.
24
15. Administrators operate the sites on a day-to-day
basis, collect a transaction fee of 8 to 15 per cent of sales
and manage escrow systems enabling the withholding of
Emily A. Vogels, Risa Gelles-Watnick and David Massarat, “Teens,
social media and technology 2022”, Pew Research Center, 10 August
2022.
25
Robert Svensson and others, “For whom do unstructured activities
matters? The interaction between unstructured and structured activities
in delinquency and cannabis use: a national self-report study”,
Crime and
Delinquency,
vol. 69, No. 10 (July 2022), pp. 2022–2045.
26
Martin, Cunliffe and Munksgaard,
Cryptomarkets;
and
World Drug
Report 2023,
booklet 2.
29
Kim Moeller, Heith Copes and Andy Hochstetler, “Advancing
restrictive deterrence: a qualitative meta-synthesis”,
Journal of Criminal
Justice,
vol. 46 (2016), pp. 82–93.
27
Thomas Friis Søgaard and others, “Ring and bring drug services:
delivery dealing and the social life of a drug phone”,
International Journal
of Drug Policy,
vol. 69 (2019), pp. 8–15; and Maria Tcherni and others,
“The dark figure of online property crime: is cyberspace hiding a crime
wave?”,
Justice Quarterly,
vol. 33, No. 5 (2016), pp. 890–911.
28
United States, Department of Justice, “Three Germans who alleg-
edly operated dark web marketplace with over 1 million users face U.S.
narcotics and money-laundering charges”, press release, 3 May 2019;
United States, Department of Justice, “Administrators of DeepDotWeb
indicted for money-laundering conspiracy”; United States, Depart-
ment of Justice, “Dozens of online ‘dark markets’ seized pursuant to the
forfeiture complaint filed on Manhattan Federal Court in conjunction
with the arrest of the operator of Silk Road 2.0”, press release, 7 Novem-
ber 2014.
30
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5
payments to sellers until delivery.
31
Estimates of the mon-
etary value of these markets vary substantially. In 2021,
UNODC suggested that the total value of the drug trade
on cryptomarkets is around $315 million annually, while
alternative estimates place total sales on individual plat-
forms at between $36 million and $221 million annually.
32
The overall value of this darknet trade may have quadru-
pled from the period 2011–2017 to the period 2017–2020.
Purchasing drugs on cryptomarkets involves a certain level
of technical literacy, and most people who use drugs are
young and educated.
33
16. Buyers have reported that they use these markets
because they provide access to drugs of a more predictable
quality. Limited forensic tests confirm that drugs sourced
from cryptomarkets are less likely to be adulterated and
have higher purity compared with offline purchases.
34
Both
buyers and sellers perceive the transactions as less risky in
terms of rip-offs, physical violence and threats compared
with street-level exchanges and even exchanges with known
dealers and friends.
35
Vendors typically operate only for
about half a year and deal with only a few buyers,
36
and
trades are generally concentrated among a few key vendors
who make most of the profits.
37
A VPN, or virtual private network, securely connects com-
puting devices or networks over the public Internet. It
extends access to private networks, enhancing security,
reducing communication costs and offering flexibility for
remote work. VPNs can bypass Internet censorship. While
encryption is common, it is not inherent to a VPN. The con-
nection is established through tunnelling protocols, and
a public Internet-based VPN can offer some benefits of a
private wide area network.
17. Most markets are in English, but the Russian language-
oriented Hydra became the world’s largest darknet market in
2019 before being taken down in 2022.
38
Shipments across
international borders have declined with time, and crypto-
markets mostly serve national markets.
39
These cryptomar-
kets may use caches or drop-off points for delivery. The seller
provides the location of the drugs using global navigation
satellite system-enabled technology on an encrypted instant
messaging app. The buyer can then pick up the drugs with-
out ever meeting the seller.
40
Recently, there has been an
emergence of marketplaces in Asia and South America,
and the overall geographical distribution of markets may
be changing, with the expansion of the darknet to those
regions.
41
18. The average transaction size on cryptomarkets is also
increasing. Apparently, there has been a shift towards an
increasing amount of wholesale sales of “ecstasy”-type drugs
and, secondarily, opioids (“wholesale” was defined as listings
priced over $1,000).
42
This trend underlines that cryptomar-
kets are anchored in offline drug markets and can serve as
virtual brokers, linking wholesalers with sellers who make
stock-sourcing purchases for offline distribution.
43
When
the scheduling of hydrocodone changed in the United States,
Anastasia Meylakhs and Ramil Saidashev, “A qualitative analysis of
the Russian cryptomarket Hydra”,
Kriminologisches Journal,
vol. 3 (2021),
pp. 169-185; and Jonathan Reed, “World’s largest darknet market shut
down, $25 million in bitcoin seized”,
Threat Hunting,
8 June 2022.
38
United States, Department of Justice, “Three Germans who alleg-
edly operated dark web marketplace with over 1 million users”; and
Martin Horton-Eddison and Matteo Di Cristofaro, “Hard interventions
and innovation in crypto-drug markets: the escrow example”, Global
Drug Policy Observatory,
Policy Brief,
No. 11 (2017), pp. 16–27.
31
Naoki Hiramoto and Yoichi Tsuchiya, “Measuring dark web mar-
ketplaces via bitcoin transactions: from birth to independence”,
Foren-
sic Science International: Digital Investigation,
vol. 35, art. No. 301086
(December 2020).
32
Venkataraman Bhaskar, Robin Linacre and Machin Stephen, “The
economic functioning of online drugs markets”,
Journal of Economic
Behavior and Organization,
vol. 159 (2019), pp. 426–441; and
World Drug
Report 2022.
33
Fernando Caudevilla and others, “Results of an international drug
testing service for cryptomarket users”,
International Journal of Drug
Policy,
vol. 35 (2016), pp. 38–41.
34
Monica J. Barratt, Jason A. Ferris and Adam Winstock, “Safer
scoring? Cryptomarkets, social supply and drug market violence”,
Inter-
national Journal of Drug Policy,
vol. 35 (2016), pp. 24–31; and Andréanne
Bergeron and others, “The success rate of online illicit drug transactions
during a global pandemic”,
International Journal of Drug Policy,
vol. 99,
art. No. 103452 (2022).
35
Lukas Norbutas, “Offline constraints in online drug marketplaces: an
exploratory analysis of a cryptomarket trade network”,
International Journal
of Drug Policy,
vol. 56 (2018), pp. 92–100; and
World Drug Report 2022.
36
David Décary-Hétu, Masarah Paquet-Clouston and Judith
Aldridge, “Going international? Risk taking by cryptomarket drug ven-
dors”,
International Journal of Drug Policy,
vol. 35 (2016), pp. 69–76; and
Jakob Demant and others, “Going local on a global platform: a critical
analysis of the transformative potential of cryptomarkets for organized
illicit drug crime”,
International Criminal Justice Review,
vol. 28, No. 3
(September 2018), pp. 255–274.
39
Scott W. Duxbury and Dana L. Haynie, “Network embedded-
ness in illegal online markets: endogenous sources of prices and profit
in anonymous criminal drug trade”,
Socio-Economic Review,
vol. 21,
No. 1 (January 2023), pp. 25–50; Scott W. Duxbury and Dana L. Haynie,
“The network structure of opioid distribution on a darknet cryptomar-
ket”,
Journal of Quantitative Criminology,
vol. 34 (2018), pp. 921–941;
and Vincent Harinam, “Dealings on the dark web: an examination of the
trust, consumer satisfaction, and the efficacy of interventions against a
dark web cryptomarket”, PhD thesis, University of Cambridge, 2021.
37
EMCDDA and Europol,
EU Drug Markets: Impact of COVID-
19;
and Meylakhs and Saidashev, “A qualitative analysis of the Russian
cryptomarket Hydra”.
40
41
42
World Drug Report 2022.
Judith Aldridge and David Décary-Hétu, “Hidden wholesale: the
drug diffusing capacity of online drug cryptomarkets”,
International Jour-
nal of Drug Policy,
vol. 35 (2016), pp. 7–15; and
World Drug Report 2023.
Samantha J. Brown, Jonathan C. Reid and Wesley Myers, “‘Let’s
talk about stealing sh*t’: online socialization and its potential to influence
offline offending”,
Crime and Delinquency
(2023); and EMCDDA and
Europol,
EU Drug Markets: Impact of COVID-19.
43
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6
INCB REPORT 2023
it coincided with a sustained increase in trading in opioids
through cryptomarkets.
44
19. Despite several widely publicized arrests of administra-
tors, the overall ecosystem has proved resilient, albeit vola-
tile.
45
Marketplaces disappear at short notice, either as a result
of law enforcement crackdowns or exit scams by administra-
tors.
46
People using these systems adapt and introduce features
that mitigate security weaknesses, for example, verification
methods that enable users to continue with their username
and reputation scores intact on a new marketplace.
47
The next
evolution appears to be a migration away from using Tor soft-
ware towards using the Invisible Internet Project (I2P) and
similar “true” darknet tools that have their own networks,
because law enforcement authorities have been able to launch
successful interventions against Tor.
48
most predominant.
49
This inappropriate content is widely
accessible to children and adolescents. Such activity is not
restricted to individual platforms. The social media land-
scape is ever-changing, and the most popular apps vary over
time and between age groups.
50
Each platform presents pro-
spective sellers with a space that can be adapted to function
as a drug marketplace.
51
21. The process of using social media to procure drugs
can start with the buyer searching drug-related hashtags or
following profiles that advertise drug sales through use of
pictures and videos of products, or captions, hashtags and
emojis on related posts. Buyers can contact a nearby seller,
who then discloses his or her contact information, typically
using messaging apps with end-to-end encryption and tem-
porary message capabilities, where the communication is
deleted after a period, or virtual private networks. The final
exchange of money for drugs usually takes place face-to-face
at the local level through a public meeting or home drop-off,
often within an hour.
52
22. Social media provides a highly convenient acquisition
method that has increased buyers’ options; this accessibil-
ity removes the age barriers found in conventional supply
chains. The use of social media to buy drugs is more wide-
spread among adolescents aged 16–17 years. Buyers who
source drugs using social media are more likely to have
lower self-control and mental health problems in the form
PGP, or Pretty Good Privacy, is a security program that
allows secure communication through message decryp-
tion and encryption, digital signature authentication and
file encryption. Developed by Phil Zimmermann in 1991, PGP
is a pioneering form of public-key cryptography software. It
encrypts and decrypts texts, emails, files and more, follow-
ing the OpenPGP standard (RfC 4880) for data encryption.
2.
Social media: increased local
availability
20. Conventional social media platforms have started to
be used as local marketplaces for illicit drugs and uncon-
trolled substances with similar effects. There are cur-
rently thousands of small-time dealers who sell drugs in
local online communities, but it is not known exactly how
widespread the problem is and in which countries it is
James Martin and others, “Effect of restricting the legal supply of
prescription opioids on buying through online illicit marketplaces: inter-
rupted time series analysis”,
BMJ,
vol. 361 (2018).
44
United States, Drug Enforcement Administration (DEA), “DEA
Washington warns of deadly counterfeit drugs on social media”, press
release, 23 July 2021; Ashly Fuller and others, “Understanding and
preventing the advertisement and sale of illicit drugs to young people
through social media: a multidisciplinary scoping review”,
Drug and
Alcohol Review
(2023).
49
David Décary-Hétu and Luca Giommoni, “Do police crackdowns
disrupt drug cryptomarkets? A longitudinal analysis of the effects of
Operation Onymous”,
Crime, Law and Social Change,
vol. 67, No. 1 (Feb-
ruary 2017), pp. 55–75; and Hiramoto and Tsuchiya, “Measuring dark
web marketplaces via bitcoin transactions”.
45
Brooke Auxier and Monica Anderson, “Social media use in 2021”
(Washington D.C., Pew Research Center, 2021); Emily A. Vogels, Risa
Gelles-Watnick and David Massarat, “Teens, social media and tech-
nology 2022” (Washington D.C., Pew Research Center, 2022); United
States, Department of Health and Human Services, Office, “Social
media and youth mental health: the U.S. Surgeon General’s Advisory”
(Washington D.C., Office of the U.S. Surgeon General, 2023).
50
Bhaskar, Linacre and Stephen, “The economic functioning of
online drugs markets”; and Joe Van Joe Van Buskirk and others, “The
recovery of online drug markets following law enforcement and other
disruptions”,
Drug and Alcohol Dependence,
vol. 173 (2017), pp. 159–162;
and
World Drug Report 2023.
46
Robin van der Sanden and others, “The use of Discord servers to
buy and sell drugs”,
Contemporary Drug Problems,
vol. 49, No. 4 (April
2022), pp. 453–477.
51
Isak Ladegaard, “Open secrecy: how police crackdowns and crea-
tive problem-solving brought illegal markets out of the shadows”,
Social
Forces,
vol. 99, No. 2 (December 2020), pp. 532–559.
47
Marie-Helen Maras and others, “Decoding hidden darknet net-
works: what we learned about the illicit fentanyl trade on AlphaBay”,
Journal of Forensic Sciences,
vol. 68, No. 5 (September 2023).
48
Silje Anderdal Bakken and Jakob Demant, “Sellers’ risk perceptions
in public and private social media drug markets”,
International Journal of
Drug Policy,
vol. 73 (2019), pp. 255–262; Jakob Demant ando others, “Drug
dealing on Facebook, Snapchat and Instagram: a qualitative analysis of
novel drug markets in the Nordic countries”,
Drug and Alcohol Review,
vol. 38, No.4 (May 2019), pp. 377–385; Leah Moyle and others, “#Drugs-
forsale: an exploration of the use of social media and encrypted messag-
ing apps to supply and access drugs”,
International Journal of Drug Policy,
vol. 63 (2019), pp. 101–110; and
World Drug Report 2023,
booklet 2.
52
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of higher psychological distress and engage in compulsive
gambling behaviour and excessive Internet use.
53
23. Limited research finds that sellers mostly advertise
cannabis and cocaine, followed by MDMA. One difference
between cryptomarkets and social media markets involves
the average quantities offered by sellers. Cocaine is offered in
smaller quantities on social media (approximately 5 grams)
compared with cryptomarkets (approximately 15 grams),
and cannabis is offered in amounts of about 10 grams on
social media compared with 20 grams on cryptomarkets.
54
This trade also involves the non-medical use of prescription
drugs. Vulnerable patient groups can access prescription
drugs for non-medical purposes through social media.
55
The United States Drug Enforcement Administration has
found counterfeit pills advertised as opioids and benzodi-
azepines on popular social media apps.
56
On Twitter, fewer
than 1 per cent of tweets related to drug sales involved the
sale of opioids. A total of 90 per cent of these had embedded
hyperlinks, but only half of them worked. The working links
usually led to websites that were illegally selling prescription
medicines.
57
posts are for precursors and newly emerging or non-
scheduled substances – and not internationally scheduled
substances – since only viewers with knowledge of those
non-scheduled substances will notice them. Business-to-
business marketplaces are more vulnerable to such misuse
than their business-to-consumer equivalents.
58
25. Under the GRIDS Programme, over 10 regional and
interregional meetings have been organized with the goal
of facilitating voluntary cooperation or public-private part-
nerships between Governments and the industries most
vulnerable to misuse, namely, the manufacturing, market-
ing, movement and monetization (4M) industries and the
Internet-related service industries.
59
The industries involved
in the meetings have extended their cooperation to areas
such as the use of e-commerce, social media, domain name
registrars and search engines, with a view to preventing the
online targeting of the 4M industries for trafficking in dan-
gerous substances, namely, new psychoactive substances,
non-medical synthetic opioids and their related chemical
precursors. Through these meetings, over 100 practical
recommendations have led to the creation of two sets of
guiding documents on the promotion of public-private
partnerships with Internet-related services, highlighting
common issues, practical recommendations and easy-to-
follow checklists for both Governments and their private
sector partners.
26. The application of the recommendations contained
in these documents has had practical results, including the
identification of suspicious listings offering high-dosage
tramadol products and ketamine hydrochloride on a major
e-commerce platform in a country in Africa. Government
authorities requested the e-commerce company to assist in
identifying the vendor, which led to arrests and seizures of
illicit products. Similarly, a major e-commerce company
operating in Latin America identified multiple suspicious
listings of kratom (Mitragyna
speciosa),
a non-scheduled
plant-based substance, and, utilizing the GRIDS Programme
focal point network, was able to share the information with
the appropriate authorities, leading to the identification and
arrest of the online seller. While these cases resulted in the
identification and arrest of those responsible for the mar-
keting of the goods and seizures of illicit substances, such
investigations are resource-intensive and in many cases,
the contacted platforms simply delete such listings, usually
within 24 hours.
3.
Legitimate e-commerce platforms
24. In the last few years, INCB global projects have pro-
moted voluntary cooperation between Governments and
e-commerce companies to prevent the misuse of their mar-
ketplaces for the illicit marketing of precursors, new psycho-
active substances and non-medical synthetic opioids. These
projects monitor the posting of offers by suspicious vendors
and purchase requests by potential buyers on major legiti-
mate e-commerce marketplaces. Most of those suspicious
Atte Oksanen and others, “Social media and access to drugs
online: a nationwide study in the United States and Spain among adoles-
cents and young adults”,
European Journal of Psychology Applied to Legal
Context,
vol. 13, No. 1 (January 2021), pp. 29–36; Robin van der Sanden
and others, “Predictors of using social media to purchase drugs in New
Zealand: findings from a large-scale online survey”,
International Jour-
nal of Drug Policy,
vol. 98, art. No. 103430 (December 2021); and van der
Sanden and others, “The use of Discord servers to buy and sell drugs”.
53
Kim Moeller, Rasmus Munksgaard and Jakob Demant, “Illicit
drug prices and quantity discounts: a comparison between a cryptomar-
ket, social media, and police data”,
International Journal of Drug Policy,
vol. 91, art. No. 102969 (2021).
54
Mackey, Liang and Strathdee, “Digital social media, youth, and
nonmedical use of prescription drugs”.
55
United States, DEA, “DEA Washington warns of deadly counterfeit
drugs on social media”.
56
Tim K. Mackey and others, “Twitter-based detection of illegal
online sale of prescription opioid”,
American Journal of Public Health,
vol. 107, No. 12 (December 2017), pp. 1910–1915; and Tim K. Mackey
and Gauurvika Nayyar, “Digital danger: a review of the global public
health, patient safety and cybersecurity threats posed by illicit online
pharmacies”,
British Medical Bulletin,
vol. 118, No. 1 (June 2016),
pp. 110–126.
57
58
59
E/INCB/2022/4.
Ibid.
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INCB REPORT 2023
4.
Internet pharmacies and telemedicine
27. As highlighted by the Board in 2009,
60
the purchase
of medicines outside legitimate supply chains was already a
growing problem at that time. Recent studies have indicated
that this issue persists in two thirds of countries worldwide
that do not have laws explicitly regulating Internet sales
of medicinal products. This poses a serious public health
concern because many consumers use the Internet to self-
diagnose and self-treat.
61
28. The online sale of medicinal products is a growing
aspect of health-care systems internationally. Internet phar-
macies are platforms that offer to sell substances that require
prescriptions, as well as illicit drugs. While there are many
legitimate and licensed pharmacies, illegal sites dominate
the global market.
62
Prescription drugs are a commonly
searched health topic on the Internet, and the global trade in
illicit pharmaceuticals is estimated to be worth $4.4 billion.
An international crackdown spearheaded by INTERPOL in
2021 shut down thousands of fake online pharmacies offer-
ing illicit products, mostly fake or unauthorized coronavirus
disease (COVID-19) testing kits. Other research supports
the observation that this is a rapidly growing phenomenon,
but the actual size of the market is unknown.
63
29. Internet pharmacies can be found through a simple
online search using the terms “pharmacy”, “pharma” or
“pharm”. Such searches elicit results that link to an Internet
address (URL) that advertises drugs for sale and contact
information. Here, the Internet pharmacies provide infor-
mation on the availability of various substances, shipping
terms and contact information on the eventual transaction
and how to exchange the product for money.
64
They also
post advertising links by commenting on social media posts
on related subjects. In the comments section, they provide
information on how to contact them using encrypted,
Guidelines for Governments on Preventing the Illegal Sale of Interna-
tionally Controlled Substances through the Internet
(United Nations publi-
cation, Sales No. E.09.XI.6).
60
61
62
third-party messaging platforms and respond to enquiries
on drug availability and prices.
65
30. A survey conducted in the United States at the height
of the COVID-19 pandemic found that 18 per cent of
respondents bought prescription medications online, using
social networking sites such as Tumblr, Wickr and Pinterest
to identify Internet pharmacies.
66
In a survey of outpatients
in Hungary, it was found that respondents who often pur-
chased goods online were more likely to buy medications
online.
67
A study comparing perceptions of safety when
purchasing prescription drugs online found that Internet
pharmacies were perceived as “relatively safe”, while the use
of encrypted communication apps (e.g. Kik, QQ, Telegram
and WeChat) to transact drug sales was perceived as less
safe. Men were more likely to perceive all online platforms
as at least somewhat safe.
68
31. The key problem with Internet pharmacies is that
no accountability exists to ensure the quality of purchased
products. Estimates suggest that 96 per cent of Internet
pharmacies fail to adhere to legal and safety requirements,
and some have even stolen customer credit card infor-
mation. It is impossible for consumers to assess whether
drugs purchased from Internet pharmacies are counterfeit,
unapproved or even illegal. The World Health Organization
(WHO) estimates that 50 per cent of medicines purchased
from illegal sites are counterfeit.
69
Falsified medicines may
be harmful, as they can contain low levels of active ingre-
dients, substandard ingredients or even the wrong ingre-
dients. Many Internet pharmacies do not ask for proof of
the required medical prescription issued by the consumer’s
physician. They may ask potential buyers to fill in a medi-
cal questionnaire, but such questionnaires are often incom-
plete.
70
Dubious marketing strategies exacerbate all these
issues. Many Internet pharmacies do not declare the side
effects of the drugs they offer for sale while advertising in a
persuasive fashion that reveals an interest in sales and profits
rather than consumer safety.
65
66
Shah, Li and Mackey, “An unsupervised machine learning approach”.
Hock, Xuan Lee and Wah Chan, “Regulating online pharmacies”.
András Fittler and others, “Consumers turning to the Internet
pharmacy market: cross-sectional study on the frequency and attitudes
of Hungarian patients purchasing medications online”,
Journal of Medi-
cal Internet Research,
vol. 20, No. 8 (August 2018); and Neal Shah, Jiawei
Li and Tim K. Mackey, “An unsupervised machine learning approach
for the detection and characterization of illicit drug-dealing comments
and interactions on Instagram”,
Substance Abuse,
vol. 43, No. 1 (2022),
pp. 273–277.
INTERPOL “Thousands of fake online pharmacies shut down in
INTERPOL operation”, 8 June 2021; INTERPOL, “USD 11 million in
illicit medicines seized in global INTERPOL operation”, 20 July 2022; and
Grazia Orizio and others, “‘Save 30% if you buy today’: online pharmacies
and the enhancement of peripheral thinking in consumers”,
Pharmacoepi-
demiology and Drug Safety,
vol. 19, No. 9 (September 2010), pp. 970–976.
63
64
Charlotte Moureaud and others, “Purchase of prescription medi-
cines via social media: a survey-based study of prevalence, risk percep-
tions, and motivations”,
Health Policy,
vol. 125, No. 11 (November 2021),
pp. 1421–1429.
Fittler and others, “Consumers turning to the internet pharmacy
market”.
67
Moureaud and others, “Purchase of prescription medicines via
social media”.
68
Hock, Xuan Lee and Wah Chan, “Regulating online pharmacies”;
Bryan A. Liang and Tim Mackey, “Searching for safety: addressing search
engine, website, and provider accountability for illicit online drug sales”,
American Journal of Law and Medicine,
vol. 35, No. 1 (2009), pp. 125–
184; and Orizio and others, “‘Save 30% if you buy today’”.
69
Orizio and others, “‘Save 30% if you buy today’”.
European Medicines Agency, “Buying medicines online”. Available
at www.ema.europa.eu; and Moureaud and others, “Purchase of prescrip-
tion medicines via social media”.
70
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9
5.
Consequences for drug trafficking
and the non-medical use of drugs
32. The Internet has increased international trade in
narcotic drugs, psychotropic substances and precursor
chemicals. Transnational organized criminal groups pur-
chase the requisite chemicals, sold as “research chemicals”,
from clandestine chemical manufacturers to produce potent
new psychoactive substances.
71
During the COVID-19 pan-
demic, those criminal groups demonstrated that they were
able to adapt and find alternative sources when lockdowns
thwarted their original suppliers.
72
With regard to the inter-
national trade in precursor chemicals, the Internet has led
to an increase in offers for these substances. Most precursor
chemicals are “dual use”, and owing to the large volumes of
licit trade, it is easy for traffickers to procure the substances,
and difficult for law enforcement authorities to detect. For
several years, suspicious online posts related to precursors
have prompted criminal investigations and led to seizures
of diverted precursors and the arrest of traffickers.
33. For Governments and law enforcement, there are
challenges associated with investigations into posts on the
surface web. The information gathered from monitoring
Internet activity and accessing search records can provide an
indication of traffickers’ interest in specific non-controlled
chemicals. For example, INCB observed a positive correla-
tion between the number of Internet search records of a
particular MDMA precursor (3,4-MDP-2-P ethyl glycidate)
and the number and scale of seizures of that same precursor.
Since the substance has no licit use, an increase in search
records concurrent with an increase in seizures may serve
as a proxy for illicit drug manufacturing.
73
34. The trend towards the use of conventional social net-
working sites and encrypted apps indicates increasingly
localized distribution in combination with rapid availability.
At the regional and local levels, the last step of drug distribu-
tion, it is difficult for law enforcement authorities to disrupt
transactions between sellers and buyers given their ability
to change meeting locations. This localized online distribu-
tion may prove to be more transformative in the longer run
than other Internet-driven supply models. The utilization of
global navigation satellite system technology and drop-off
caches may further exacerbate this growth in availability.
35. That availability has also increased the types of drugs
that are otherwise difficult to procure in conventional mar-
kets.
74
Hallucinogens such as lysergic acid diethylamide
(LSD) and psilocybin (hallucinogenic mushrooms) are
widely available online. Other strictly regulated substances
containing narcotic drugs and psychotropic substances are
also available through Internet-based markets. The misuse
of prescription psychiatric drugs is an increasing global
health problem. These products encompass sedatives, cen-
tral nervous system stimulants and other drugs, including
antidepressants, antipsychotics, mood stabilizers and anti-
dementia drugs. Although they are available online, their
presence is still negligible. An important exception is drugs
used in the treatment of opioid dependency; these have a
substantial online presence, not only in the United States
but also in Europe.
75
36. The online presence of fentanyl and other synthetic
opioids is a serious cause for concern. The continuous intro-
duction of new and modified versions of synthetic opioids
challenges regulatory and law enforcement authorities
internationally.
76
Many cryptomarkets have rules against
fentanyl, and administrators attempt to ban predatory ven-
dors, but such vendors still manage to sell it covertly. About
10 per cent of cryptomarket drug listings are for opioids,
and less than 1 per cent of all drug advertisements are for
fentanyl. With some 300 active fentanyl vendors, there was
an estimated 27.3 to 39.3 kg on the market during the period
2 January to 27 March 2019
77
(1 kg of fentanyl has the poten-
tial to kill 500,000 people).
78
6. Online information-sharing
37. People who use drugs share tips and dosing advice on
various discussion forums.
79
While this information-sharing
reflects an increase in marketing, it can also strengthen
74
75
World Drug Report 2023,
booklet 2.
Jack Cunliffe, David Décary-Hêtu and Thomas A. Pollak, “Non-
medical prescription psychiatric drug use and the darknet: a cryptomarket
analysis”,
International Journal of Drug Policy,
vol. 73 (2019), pp. 263–272;
and Isak Ladegaard, “Instantly hooked? Freebies and samples of opioids,
cannabis, MDMA, and other drugs in an illicit E-commerce market”,
Journal of Drug Issues,
vol. 48, No. 2 (April 2018), pp. 226–245.
Kim Moeller and Bengt Svensson, “‘Shop until you drop’: valuing
fentanyl analogs on a Swedish Internet forum”,
Journal of Drug Issues,
vol. 51, No. 1 (January 2021), pp. 181–195; and Pardo and others, “The
dawn of a new synthetic opioid era”.
76
Jonathan Caulkins, “Radical technological breakthroughs in drugs
and drug markets: the cases of cannabis and fentanyl”,
International Jour-
nal of Drug Policy,
vol. 94, art. No. 103162 (August 2021); and Bryce Pardo
and others, “The dawn of a new synthetic opioid era: the need for innova-
tive interventions”,
Addiction,
vol. 116, No. 6 (June 2021), pp. 1304–1312.
71
Roderic Broadhurst, Matthew Ball and Harshit Trivedi, “Fentanyl
availability on darknet markets”,
Trends and Issues in Crime and Crimi-
nal Justice,
vol. 590 (2020), pp. 1–14; and Maras and others, “Decoding
hidden darknet networks”.
77
World Drug Report 2021,
booklet 5,
COVID-19 and Drugs: Impact
and Outlook
(United Nations publication, 2021).
72
73
United States, DEA, “Facts about fentanyl”. Available at
www.dea.gov/resources/facts-about-fentanyl.
78
E/INCB/2022/4, paras. 201–203.
Aldridge, Stevens and Barratt, “Will growth in cryptomarket drug
buying increase”.
79
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INCB REPORT 2023
efforts to reduce the adverse consequences of drug use.
Drug-checking services can achieve a wider reach by using
the Internet to communicate warnings. Such services ana-
lyse samples often provided by people who use “ecstasy”
in connection with the electronic dance music scene. They
can identify discrepancies between what people who use
drugs think they are using and what they are actually con-
suming. The Internet provides a vehicle for rapidly sharing
this information with other people using these substances.
In cases where drugs are adulterated with dangerous sub-
stances or have unusually high potency, this information can
save lives. Most people seeking information on a drug have
never been in touch with drug-checking services before and
may harbour a sceptical attitude towards warnings issued by
official authorities. An additional benefit of drug-checking
services is the identification of new psychoactive substances,
which can then be communicated to authorities such as the
European Union Early Warning System.
80
38. There are several discussion forums dedicated to
cryptomarket-related topics. Initially, libertarian political
discussions were prominent, but they subsided in favour
of discussions on more practical logistical issues, such as
warnings against fraudulent vendors, unreliable administra-
tors and online security measures. People also discuss the
inherent risks of drug use, and because the forums do not
prohibit discussions about trafficking, this information can
be highly localized and includes warnings about adulterated
drugs encountered.
81
While this knowledge-sharing is a pos-
itive element, it is unlikely to be associated with significant
reductions in health-related costs, as cryptomarket users are
seldom the most vulnerable among people who use drugs.
82
39. With regard to types of drugs that can be manufac-
tured by people who use drugs themselves, instructions on
how to do so at low risk can be shared online. Instead of rely-
ing on synthesizing regulated precursors for methampheta-
mine production, people have learned to extract them from
processed products that are legal to acquire, and have shared
the procedures online.
83
A recent trend involves shifting to
custom-made precursors, often “disguised precursors”, that
are closer to the desired end products and thus require little
chemical processing.
84
40. Another unintended side effect of knowledge diffu-
sion through use of the Internet is seen in the influence
on the social and cultural norms associated with drug use.
The legalization of cannabis in some jurisdictions may have
inadvertently reduced informal social control related to can-
nabis in jurisdictions where it is illegal, contributing to its
further normalization. Social media influencers and dispen-
saries in regions where cannabis is legal promote its use as
part of a healthy lifestyle, despite the known health risks.
85
7.
International treaties
41. The international drug control conventions can serve
as a foundation for extradition and mutual legal assistance.
Article 6 of the 1988 Convention covers extradition, and
article 7 of the Convention covers mutual legal assistance.
Both of these articles are relevant today, even though the
Convention predates the widespread use of the Internet.
Article 7, paragraph 2, states that mutual legal assistance may
be requested for any of the following purposes:
(a) taking
evidence or statements from persons;
(b)
effecting service
of judicial documents;
(c)
executing searches and seizures;
(d)
examining objects and sites;
(e)
providing information
and evidentiary items;
(f)
providing originals or certified
copies of relevant documents and records, including bank,
financial, corporate or business records; and
(g)
identify-
ing or tracing proceeds, property, instrumentalities or other
things for evidentiary purposes.
42. To strengthen these efforts further, Member States
are currently negotiating a new United Nations cybercrime
convention on countering the use of information and com-
munications technologies for criminal purposes. Various
international organizations (INTERPOL, UNODC, WCO
and WHO) are making use of the Internet to improve drug
control, and existing international conventions address
issues of cybercrime, but there is currently no legally binding
international instrument on the subject. A diverse range of
Silvia L. Cruz and Raúl Martín-del-Campo, “Synthetic opioids as
new psychoactive substances (NPS)”, in
Opioids: Pharmacology, Abuse,
and Addiction,
Silvia L. Cruz, ed. (Cham, Switzerland, Springer Inter-
national Publishing, 2022). pp. 363–383.
84
Claudio Vidal Giné and others, “The utility of drug checking ser-
vices as monitoring tools and more: a response to Pirona et al.”,
Inter-
national Journal of Drug Policy,
vol. 45 (2017), pp. 46–47.
80
Bancroft, “Responsible use to responsible harm”; and Martin,
Cunliffe and Munksgaard,
Cryptomarkets.
81
82
83
Sumnall, “The harm reduction impact of cryptomarkets”.
Sabrina Vidal and David Décary-Hétu, “Shake and bake: explor-
ing drug producers’ adaptability to legal restrictions through online
methamphetamine recipes”,
Journal of Drug Issues,
vol. 48, No. 2 (January
2018), pp. 269–284.
Silje Anderdal Bakken and Sidsel Kirstine Harder, “From deal-
ing to influencing: online marketing of cannabis on Instagram”,
Crime,
Media, Culture: An International Journal,
vol. 19, No. 1 (March 2023),
pp. 135–157; Brown, Reid and Myers, “‘Let’s talk about stealing sh*t’”;
Samantha Hoeper and others, “‘The perfect formula:’ evaluating health
claims, products and pricing on cannabis dispensary websites in two
recently legalized States”,
Substance Use and Misuse,
vol. 57, No. 8 (May
2022), pp. 1207–1214; and Isak Ladegaard, “Cleansing frames: how
digital ‘consumer reports’ of cannabis and psychedelics normalise drug-
taking and neutralise its counter-cultural potential”,
Sociology
(2023).
85
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ChAPTER I. ThE ROLE Of ThE INTERNET, INCLuDING SOCIAL mEDIA, IN DRuG TRAffICkING AND uSE
11
stakeholders is providing input for the cybercrime conven-
tion: intergovernmental organizations, non-governmental
organizations in consultative status with the Economic and
Social Council, as well as other non-governmental organi-
zations, civil society organizations, academic institutions
and companies from the private sector. On the basis of
written submissions from Member States, the cybercrime
convention will contain chapters on criminalization, gen-
eral provisions, procedural measures and law enforcement,
international cooperation, technical assistance, preventive
measures, the mechanism of implementation and final
provisions.
systems. Search engine companies require the “verification”
of Internet drug sellers but are not legally accountable for
facilitating illegal activities. Internet pharmacies based in
the European Union must display a common logo on their
website that directs to an online list of verified Internet
pharmacies.
89
9. Law enforcement action
45. The task of keeping track of all the various synthetic
opioids and their analogues and precursors requires interna-
tional cooperation. National law enforcement agencies need
to be equipped with knowledge about the different names
used for the chemicals and equipment in order to investigate
suspicious posts on the surface web relating to the sale of
precursor chemicals. It also requires voluntary cooperation
with the private Internet industry and Government-initiated
monitoring mechanisms to probe leads shared by INCB.
90
Leads provided by INCB on suspicious Internet posts related
to precursors have resulted in seizures and the dismantling
of criminal networks. In 2018, an investigation led to the
seizure of nearly 10 tons of acetic anhydride, ephedrine and
ketamine, as well as the identification of a methampheta-
mine shipment destined for Australia in 2022.
91
46. Law enforcement and national judiciary authori-
ties need to be equipped with the necessary tools and
resources to respond in a coordinated manner. Trafficking
and cybercrime are both priorities, and authorities should
pursue multi-agency approaches, engage with industry and
establish online investigations units, joint operational inter-
national task forces and coordinated actions.
92
Some experts
on the investigation of cybercrime note that they currently
face legal obstacles in fighting trafficking in precursors,
specifically with regard to barriers to the retention of data
relating to the registration of Internet protocol addresses
and domains.
47. Law enforcement agencies have successfully applied
novel investigative measures against trafficking in precur-
sors and non-scheduled chemicals. These measures include
European Medicines Agency, “Buying medicines online”;
Hock, Xuan Lee and Wah Chan, “Regulating online pharmacies”;
E/INCB/2022/4; and Liang and Mackey, “Searching for safety”.
89
90
91
8. Regulatory efforts
43. National regulatory responses to synthetic opioids and
their precursors range from the blanket criminalization of
all substances related to a given chemical compound, to
individual assessments of substances. When a few coun-
tries have less restrictive policies or do not enforce them, it
enables others to exploit those loopholes.
86
With regard to
synthetic opioids and related substances, this enables offend-
ers to exploit the differences in national regulations and to
purchase products in one jurisdiction and sell them at a pre-
mium in another. All the steps in this distribution chain are
conducted online.
87
Some Governments have put in place
specific legislation or regulations that cover Internet posts
relating to precursors. According to INCB information, this
is the case in India, Thailand, the United Arab Emirates and
the United States.
44. Illicit Internet pharmacies threaten global patient
safety by selling drugs without a prescription directly to
the consumer. The current legal, regulatory and law enforce-
ment responses are inadequate. To stem the tide, regulatory
authorities are increasingly attempting to use accredita-
tion programmes to address these concerns.
88
The Board
is aware of specific regulations applied in some countries,
such as China, where all entities that sell precursors over the
Internet are required to register with the competent national
authorities. Some experts propose making Internet drug
sales contingent on licensing through national Internet
pharmacy programmes, even suggesting criminal penalties
for all parties, including websites, search engines and health-
care providers. In 2014, the “pharmacy” domain scheme
was introduced to complement national accreditation
86
87
E/INCB/2021/4.
Ibid.
World Drug Report 2022.
Pardo and others, “The dawn of a new synthetic opioid era”; Peter
Reuter, Bryce Pardo and Jirka Taylor, “Imagining a fentanyl future: some
consequences of synthetic opioids replacing heroin”,
International Journal
of Drug Policy,
vol. 94, art. No 103086 (August 2021).
Hock, Xuan Lee and Wah Chan, “Regulating online pharmacies”;
and Mackey and Nayyar, “Digital danger”.
88
EMCDDA and Europol,
EU Drug Markets: Impact of COVID-19;
Harinam, “Dealings on the dark web”; Mehdi Najafi, Hossein Zolfagharinia
and Fatemeh Asadi, “Angels against demons: fight against smuggling in
an illicit supply chain with uncertain outcomes and unknown structure”,
Computers and Industrial Engineering,
vol. 176, art. No. 109007 (2023); and
Lukas Norbutas, Stijn Ruiter and Rense Corten, “Believe it when you see it:
dyadic embeddedness and reputation effects on trust in cryptomarkets for
illegal drugs”,
Social Networks,
vol. 63 (2020), pp. 150–161.
92
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INCB REPORT 2023
the setting up of fake online advertisements for precur-
sors or non-scheduled chemicals on business-to-business
websites or social media or other platforms, and the use of
sting operations to gather information on both prospective
buyers and sellers of related chemicals. Further access to
undercover activities would increase efficiency and enable
better cross-border cooperation, including electronic data
exchange, in investigations.
93
INCB conducted a training
exercise on the investigation of suspicious Internet posts
relating to precursor chemicals in June 2023. This high-
lighted the value of tailored training on the specificities of
precursor-related Internet posts, which often appear on the
surface web, in contrast to new psychoactive substance end
products, which mostly appear on the darknet.
D. INCB support to Governments to
prevent exploitation of the
Internet
48. In 2009, the Board issued the Guidelines for Govern-
ments on Preventing the Illegal Sale of Internationally
Controlled Substances through the Internet, which recom-
mended a wide range of actions, including administra-
tive, legislative and regulatory provisions, to be taken by
Governments to curb the illegal sale of internationally
controlled substances, as recognized in Commission on
Narcotic Drugs resolution 58/3.
49. In addition, the Board has developed practical tools to
facilitate the international trade in internationally controlled
narcotic drugs and psychotropic substances to ensure the
availability of these substances for medical and scientific
purposes. Those tools include the International Import
and Export Authorization System (I2ES), and the INCB
International Drug Control System (IDS) which enables the
Board to monitor the utilization of controlled substances.
To facilitate the international trade in precursor chemi-
cals while preventing diversion into illicit channels, and
to support Governments in addressing trafficking in new
psychoactive substances and non-medical synthetic opioids
not under international control, INCB has also developed
online systems to monitor trade and facilitate governmental
cooperation, information exchange and joint investigations.
These tools include PEN Online, PEN Online Light, PICS,
IONICS and GRIDS Intelligence. To build the capacity of
Governments to implement the three international drug
control conventions, INCB Learning e-modules are available
to competent national authorities.
93
50. A further area in which INCB global projects have
successfully promoted voluntary cooperation between
Governments and e-commerce companies to prevent the
misuse of their marketplaces was, in 2021, the targeted,
time-bound Operation Acronym focused on trafficking in
precursors over the surface web. INCB further assisted in
identifying practical obstacles and legal challenges to inves-
tigations related to precursors and cybercrime. The obstacles
and challenges identified included the following:
(a)
a lack
of national regulations concerning the offering for sale or
distribution, or the mediating in the sale or purchase, of
precursors through a website or social media;
(b)
hesita-
tion to initiate investigations into suspicious posts because
they might represent scams rather than legitimate trade in
precursors; and
(c)
a lack of sufficient proof of the buyer’s or
vendor’s knowledge that a precursor proposed to be sold or
bought online was intended to be used for the illicit manu-
facture of drugs, leading to a perceived lack of legal grounds
to support the initiation of criminal investigations.
94
These
obstacles and challenges need to be addressed in order to
improve national authorities’ ability to launch investigations
into suspicious online posts.
51. The global nature of online drug distribution makes
collaborative efforts necessary. Reducing trafficking in illic-
itly manufactured precursors requires recognition of the
shared responsibility for preventing their diversion from
licit channels and cooperation between national authori-
ties and industry sectors.
95
These efforts are increasingly
important for identifying new threats and developing
effective responses. The GRIDS Programme builds national
capacity to address trafficking in new psychoactive sub-
stances, synthetic opioids and their precursors and supports
Governments in developing public-private partnerships
to prevent the exploitation of the Internet-related service
industry, including e-commerce marketplaces, social media,
search engines and domain name registries/registrars.
96
The
GRIDS Programme consists of online tools that provide the
infrastructure to exchange information on organized crimi-
nal groups. These tools help prevent trafficking through the
misuse of legitimate Internet-related services and include
monitoring and surveillance lists for substances with no
known legitimate uses. Such substances are used as substi-
tutes for controlled precursors.
52. IONICS enables Governments to share informa-
tion in real time on incidents involving new psychoactive
substances and non-medical synthetic opioids, while the
GRIDS Intelligence tool facilitates communication between
Governments on incidents relating to these dangerous
94
95
Ibid.
E/INCB/2017/4 and E/INCB/2016/1.
E/INCB/2022/1.
E/INCB/2022/4.
96
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ChAPTER I. ThE ROLE Of ThE INTERNET, INCLuDING SOCIAL mEDIA, IN DRuG TRAffICkING AND uSE
13
substances, including instances in which they are being
offered on the Internet.
53. Partnerships with the relevant business-to-business
companies are an important element of efforts to provide an
effective deterrent to the exploitation of the surface web for
trafficking in precursors.
97
The GRIDS Programme provides
a platform to foster cooperation with private sector part-
ners working in relevant areas, namely, payment services,
chemical and drug manufacturers, postal services, express
courier services, freight forwarders, air cargo agents and
private postal, express mail and courier services, as well as
domain name registrars and newly emerging financial ser-
vices and products such as e-wallet services, virtual asset
service providers and cryptocurrencies. The outcomes of
the dialogues between Governments and these sectors have
been compiled into several practical guidance publications
for practitioners’ reference and use.
54. The GRIDS Programme also informs major e-commerce
and social media companies that are keen to maintain their
platforms free of illicit activities involving offers of suspi-
cious and dangerous substances. The guidance provided
includes information on voluntary cooperation measures,
the monitoring of and investigations into suspicious posts
and the adoption of a balanced approach to preventing
Internet-facilitated diversion and smuggling.
98
Recent
experiences from targeted operations supported by INCB
indicate that follow-up investigations to identify prospective
buyers and sellers are also needed to achieve lasting results.
Darknet administrators are targeted in law enforcement
crackdowns, arrested and prosecuted. Despite the appear-
ance of new cryptomarkets and the migration of users to
them after law enforcement crackdowns, the efforts are not
in vain. Targeting the most active offenders reduces crime
and creates uncertainty for others involved. That extra
uncertainty adds costs throughout the distribution chain, as
the demands on operational security procedures increase.
100
56. Further, adding an element of communication may
improve the efficiency of crackdowns.
101
While the Internet
makes it difficult to identify targets, it also makes it much
easier to contact them. Authorities could communicate
to very active vendors that they are being specifically tar-
geted in a programme, and that law enforcement is aware
of their activities and is working on de-anonymizing them.
This effort is complementary to arrests and is aimed at dis-
couraging users, similar to how warning banners reduce
the duration of other types of cybercrime.
102
Like all co-
offending, the online trade in controlled drugs hinges on
trust between sellers and buyers. This trust includes trust
in the technical competencies of the platform administra-
tors. Successful examples of disrupting that trust include
the takeover of sites by law enforcement agencies, which
then continue to run the site after arresting the original
administrator. Such actions can reduce the overall level of
trust among buyers and sellers in the technical infrastruc-
ture of the online drug trade, similar to how infiltration by
undercover police officers places pressure on drug dealers
to adapt their practices.
103
57. The Internet also provides new avenues for public
health and community responses that implement strate-
gies for preventing drug use, providing treatment, aftercare
and achieving social reintegration. Community participa-
tion and civil society play important roles in that regard.
United States, Department of Justice, “Three Germans who
allegedly operated dark web marketplace with over 1 million users”;
Department of Justice, “Administrators of DeepDotWeb indicted for
money-laundering conspiracy”; Décary-Hétu and Giommoni, “Do
police crackdowns disrupt drug cryptomarkets?”; Isak Ladegaard, “We
know where you are, what you are doing and we will catch you: testing
deterrence theory in digital drug markets”,
British Journal of Criminol-
ogy,
vol. 58, No. 2 (March 2018), pp. 414–433; and Harold A. Pollack and
Peter Reuter, “Does tougher enforcement make drugs more expensive?”,
Addiction,
vol. 109, No. 12 (December 2014), pp. 1959–1966.
100
E. Law enforcement, public health
and community responses to
address the non-medical use of
drugs
55. From a law enforcement perspective, the scale and
diversity of illegal Internet-based activity pose considerable
challenges for the implementation of the international drug
control conventions. Law enforcement agencies worldwide
struggle to establish a credible deterrent threat for traffick-
ing offences in the online context, at both the wholesale and
retail levels. Focused deterrence can increase the disruptive
effects of law enforcement by prioritizing targets based on
predefined high-value or high-risk transaction criteria.
99
97
98
99
Nicholas Corsaro, Rod K. Brunson and Edmund F. McGarrell,
“Problem-oriented policing and open-air drug markets: examining the
Rockford pulling levers deterrence strategy”,
Crime and Delinquency,
vol. 59, No. 7 (October 2013), pp. 1085–1107.
101
E/INCB/2022/4.
E/INCB/2021/1.
David Maimon and Eric R. Louderback, “Cyber-dependent
crimes: an interdisciplinary review”,
Annual Review of Criminology,
vol. 2
(2019), pp. 191–216.
102
EMCDDA and Europol,
EU Drug Markets: Impact of COVID-19;
Najafi, Zolfagharinia, and Asadi, “Angels against demons”.
Bruce A. Jacobs, “Deterrence and deterrability”,
Criminology,
vol. 48, No. 2 (May 2010), pp. 417–441; and Rasmus Munksgaard and
others, “Better bang for the buck? Generalizing trust in online drug mar-
kets”,
British Journal of Criminology,
vol. 63, No. 4 (July 2023), pp. 906–928.
103
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14
INCB REPORT 2023
Drug-checking services are an example that constitutes a
form of peer education, information-sharing and counsel-
ling, and can even contribute to early warning systems for
new psychoactive substances. While those health and com-
munity responses have positive attributes, it is important to
note that the objective of such measures should be to reduce
the adverse consequences of non-medical drug use without
condoning or encouraging drug trafficking.
104
F.
Conclusions and
recommendations
58. The Internet offers potential for improving inter-
national drug control and preventing non-medical drug
use. The international trade in controlled substances for
medical, scientific and industrial purposes is facilitated
through the Internet. Licit Internet pharmacies and tele-
medicine enable patients in remote locations to access essen-
tial medicines and consultations. Ongoing research at the
global and national levels can improve the early detection
of potential misuse of the Internet and detect non-licensed
Internet pharmacies. The online sharing of information
among people who use drugs and public health, and com-
munity services can reduce the adverse consequences of
the non-medical use of drugs, serve as an early warning of
new drug use patterns and connect people who use drugs
with treatment and other health services. The primordial
objective of Government action in this area remains the
prevention of substance abuse, in particular among young
people.
105
The Board recommends that Governments con-
duct drug abuse prevention campaigns, using awareness-
raising messages on drug-related risks circulated using
social media.
59. However, the Internet also provides new opportuni-
ties for trafficking in and the non-medical use of controlled
drugs. The various forms of Internet-facilitated drug and
precursor trafficking outlined in this chapter constitute
transnational cybercrimes that require effective regulatory
and technological actions by Governments, international
organizations, and the private sector. The challenges posed
by the various incarnations of Internet-facilitated drug
trafficking – the use of cryptomarkets, social networking
sites, encrypted apps, e-commerce platforms and illicit
Internet pharmacies – all require legislative and policy meas-
ures to address their unique roles in trafficking in narcotic
drugs, psychotropic substances and precursor chemicals.
106
The global proliferation of legitimate online platforms for
communication and trade in goods and services enables
illegal traders to adapt such platforms to achieve their
ends. Global communication and commerce increasingly
rely on advances in information technology and digitaliza-
tion. These advances also facilitate illegal activities, as more
criminal offences are occurring online while merging with
criminal offences occurring offline.
107
Even at the highest
levels of the illicit global drug trade, contact is facilitated
by the Internet and encrypted communications and growth
in drug distribution using social media leads to an increase
in the promotion of drugs at the regional level, increased
availability and knowledge-sharing between people who use
drugs.
108
Governments are therefore urged to ensure that
the legal and operational means are available to prosecute
illegal marketplaces operating on social media platforms.
60. Meeting these challenges requires cooperation
between international organizations, national Governments,
regulatory authorities and private companies working in
the relevant sectors. The issues associated with identifying
illegal content on the Internet are not limited to trafficking
in narcotic drugs, psychotropic substances and precursor
chemicals. This question concerns a much broader problem
of addressing online content that promotes illegal behav-
iours. Finding an appropriate balance between the interests
of individuals, the public and the businesses concerned is
difficult and contingent on time and place. Different coun-
tries have very different legal traditions, which complicates
efforts to restrict an international phenomenon. The inter-
national community needs to consider this issue collectively,
drawing on the expertise, across various organizations, of
specialists in cybercrime and money-laundering as well as
trafficking in drugs and firearms, counterfeiting and other
forms of smuggling.
109
61. These ongoing efforts are currently reliant on vol-
untary cooperation between Governments and social
media companies. Internet-facilitated drug trafficking
using conventional social media requires new and concur-
rent responses based on public-private partnerships. The
potential for restricting this trade can be illustrated by the
international cooperation around improved cooperation
with Internet pharmacies. The aim is to engage the public
and private sectors and civil society in new and innovative
Hoffman, “Shedding light on telemedicine and online prescrib-
ing”; Mackey and Nayyar, “Digital danger”; and Tim K. Mackey, Liang
and Strathdee, “Digital social media, youth, and nonmedical use of pre-
scription drugs”.
106
EMCDDA and Europol,
EU Drug Markets: Impact of COVID-19;
and Maimon and Louderback, “Cyber-dependent crimes”.
107
104
105
E/INCB/2016/1.
E/INCB/2019/1.
108
109
World Drug Report 2023,
booklet 2.
E/INCB/2022/1.
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Chapter I. the role of the Internet, InCludIng soCIal medIa, In drug traffICkIng and use
15
ways.
110
Law enforcement investigations are most efficient
when delivery couriers, financial service providers and
Internet companies help enforce e-commerce regulations.
Public-private partnerships aimed at regulating the e-com-
merce of medicinal products effectively should consist of
implementing industry guidelines, advisories and warn-
ings. Legislation should address the risks associated with
illegitimate Internet pharmacies. Legal frameworks are
fundamentally national and extradition requests involv-
ing suspects need to be harmonized on the basis of treaties
or conventions.
111
The Board encourages States parties to
develop private sector partnerships with those vulnerable-
to-exploitation private sector entities to foster voluntary
actions to protect the integrity, reputation and security of
their services. This includes allocating sufficient resources
and building national capacities and capabilities in the field
of online investigations and improved cooperation at the
national and international levels to develop an early detec-
tion system for Internet-based offences.
62. This requires a longer-term effort to build international
consensus and improve the capacity of Governments to engage
with the private sector. Public-private partnerships should
include key industries, academia and non-governmental
organizations working with people who use drugs in the
development of effective responses. INCB is active in this
area and, through Governments, engages several key indus-
tries from the private sector in the form of social media com-
panies, online payment services and information technology
providers.
112
The global nature of the Internet-based services
used for trafficking gives rise to difficult questions regarding
the provision of mutual legal assistance between national
Governments and regulatory agencies. International action
against traffickers is complicated by jurisdictional issues and
differences in national legal standards relating to the authen-
ticity of evidence gathered and the chain of evidence.
63.
In particular, with regard to the Board’s efforts
under its GRIDS Programme to assist Governments in
addressing the threat posed by synthetic drugs, States
parties are encouraged to:
•
Identify private sector companies, industry asso-
ciations and related stakeholders vulnerable to
exploitation by traffickers of synthetic drugs,
such as business-to-business, business-to-con-
sumer and search engine services, Internet regis-
tries/registrars, social media and online financial
services, so that they may work with them to help
110
111
112
prevent the trafficking of dangerous substances
using Internet-related services.
•
Use the OPIOIDS project’s fentanyl-related
substances list, and the Project’s other lists of
dangerous substances with no known legitimate
medical, scientific or industrial use, to encourage
industry partners voluntarily to refrain from any
manufacture, marketing, import, export or dis-
tribution of the substances on those lists except
for the purposes of research and analysis.
•
Work with the GRIDS Programme to facilitate
public-private partnership engagement, dia-
logue and cooperation between Governments
and industry using tools such as the Board’s
“Practical guidance for voluntary cooperation
for e-commerce and Internet-related services by
Government and industry to prevent trafficking
of synthetic opioids, fentanyls and related dan-
gerous substances”.
•
Nominate active GRIDS Programme enforce-
ment focal points in their national police,
customs, postal, health regulatory and drug
control agencies to exchange suspicious ship-
ment and seizure information through the INCB
IONICS system to help foster joint actions with
the private sector to deny, disrupt and dismantle
trafficking networks that exploit Internet-related
and e-commerce services.
•
Utilize the real-time counter-trafficking tools
available through IONICS, including GRIDS
Intelligence HD, ELITE and other tools, to
develop actionable intelligence that identifies
and links traffickers that exploit Internet-related
and e-commerce services.
E/INCB/2021/1.
Hock, Xuan Lee and Wah Chan, “Regulating online pharmacies”.
EMCDDA and Europol,
EU Drug Markets: Impact of COVID-19;
and E/INCB/2022/1.
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Chapter II.
Functioning of the international drug
control  system
A. Promoting the consistent
application of the international
drug control treaties
64. The international drug control legal framework con-
sists of the Single Convention on Narcotic Drugs of 1961,
as amended by the 1972 Protocol, the Convention on
Psychotropic Substances of 1971 and the United Nations
Convention against Illicit Traffic in Narcotic Drugs and
Psychotropic Substances of 1988. Together, these three
instruments have been recognized by the international com-
munity as constituting the cornerstone of the international
drug control system.
65. These conventions establish the legal framework for
the licit trade in narcotic drugs, psychotropic substances and
precursor chemicals. They require States parties to create
administrative structures responsible for monitoring the
production and manufacture of and trade in substances
scheduled under the conventions and they establish obli-
gations for States parties to report to the Board on, inter
alia, their expected licit requirements, actual consumption,
international trade and seizures.
66. The conventions are aimed at fostering the availability
of controlled substances for medical, scientific or industrial
use while preventing their diversion into illicit channels.
They also limit the production, manufacture, export, import
and distribution of, trade in and possession of drugs exclu-
sively to medical and scientific purposes.
67. In addition, the conventions contain provisions related
to the treatment of drug-related behaviours, including the
obligation for States parties to make certain drug-related
behaviours punishable offences. Furthermore, they provide
that criminal justice responses to suspected drug-related
crime should be consistent with the principle of proportion-
ality and, accordingly, that crimes of lesser gravity may be
subject to lesser penalties and crimes committed by people
who use drugs may be dealt with through alternative meas-
ures to conviction or punishment, including measures of
treatment, education, aftercare, rehabilitation and social
reintegration.
68. The conventions also provide a legal basis for inter-
national cooperation, extradition and mutual legal assistance
and require States parties to develop strategies aimed at pre-
vention, and frameworks for the treatment and rehabili-
tation of people affected by drug use and dependence.
1.
Status of adherence to the
international drug control treaties
69. The international drug control conventions continue
to number among the most widely ratified international
instruments, enjoying near universal adherence.
70. As at 1 November 2023, the 1961 Convention as
amended had been ratified or acceded to by 186 States.
Only 10 States had yet to become parties, namely, the Cook
Islands, Equatorial Guinea, Kiribati, Nauru, Niue, Samoa,
South Sudan, Timor-Leste, Tuvalu and Vanuatu. Chad has
ratified the 1961 Convention in its unamended form.
71. The number of States parties to the 1971 Convention
remained at 184 during the period under review. Thirteen
States had not yet become parties to that Convention,
namely, the Cook Islands, Equatorial Guinea, Haiti, Kiribati,
17
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18
INCB REPORT 2023
Liberia, Nauru, Niue, Samoa, Solomon Islands, South
Sudan, Timor-Leste, Tuvalu and Vanuatu.
72. The 1988 Convention remains the most widely ratified
of the three international drug control conventions, having
192 parties (191 States and the European Union) after
South Sudan deposited its accession on 20 October 2023.
Equatorial Guinea, Kiribati, Papua New Guinea, Solomon
Islands, Somalia and Tuvalu have yet to accede.
73.
The Board reiterates that universal ratification of the
drug control conventions is imperative for strengthening
the international drug control legal framework and for
ensuring that traffickers do not target non-parties owing
to actual or perceived weaknesses in the scope of control
of scheduled substances.
74.
Consequently, and in the spirit of common and
shared responsibility, the Board encourages those States
that have yet to accede to one or more of the inter-
national drug control conventions to do so without
delay and to ensure their comprehensive implementa-
tion into national law. To that end, in the exercise of
its mandate, INCB stands ready to assist in whatever
manner is needed.
77. The scheduling decision became fully effective on
13 November 2023, namely, 180 days after the date of com-
munication by the Secretary-General.
Precursor chemicals
78. In June 2023, the Board notified the Secretary-General
of two series of closely related precursors of, respectively,
amphetamine and methamphetamine, and “ecstasy”-type
substances, proposing that they be included in the tables of
the 1988 Convention. The proposal was made in response to
a significant increase in seizures of P-2-P methyl glycidic acid
and its methyl ester (“BMK glycidate”), and of the ethyl ester
of 3,4-MDP-2-P methyl glycidic acid (“PMK ethyl glycidate”),
which are alternative precursors to, respectively, P-2-P and
3,4-MDP-2-P, two precursors already under international
control. The proposal, to include a total of 16 substances
(esters and acids), was also made in line with Commission
on Narcotic Drugs resolution 65/3 of March 2022.
79. In addition, in July 2023, the Government of the
United States of America proposed that two precursors of
fentanyl and fentanyl-related substances, namely, 4-piperi-
done and 1-boc-4-piperidone, also be included in the tables
of the 1988 Convention.
80. Pursuant to the procedure set out in article 12, para-
graph 3, of the 1988 Convention, Governments were invited
to submit their comments and supplementary information
for each of the 18 chemicals listed in the proposals to assist
the Board in establishing assessments and making sched-
uling recommendations to the Commission on Narcotic
Drugs at its sixty-seventh session.
81. In November 2023, following the analysis of informa-
tion received from Member States, INCB recommended
the scheduling of all 18 substances in Table I of the 1988
Convention. The Commission on Narcotic Drugs was to
vote on the proposals in March 2024.
2.
Changes to the scheduling of
substances under international
control
Narcotic drugs
75. On 15 March 2023, at its sixty-sixth session, the
Commission on Narcotic Drugs decided, on the basis of
the recommendations by WHO, to place etazene, etonit-
azepyne, 2-methyl-AP-237 and protonitazene in Schedule I
of the 1961 Convention as amended. The decision of the
Commission became effective with respect to each party
on the date of receipt of the official communication by the
Secretary-General.
3.
Psychotropic substances
76. Also at its sixty-sixth session, the Commission on
Narcotic Drugs decided, by its decisions 66/5, 66/6 and 66/7,
to include ADB-BUTINACA,
alpha-PiHP
and 3-methyl-
methcathinone in Schedule II of the 1971 Convention,
bringing the total number of substances controlled under
the 1971 Convention to 170.
Submission of information by
Governments to the Board
(a) Statistical reports for narcotic drugs,
psychotropic substances and precursor
chemicals
82. In accordance with its mandate, the Board publishes
its annual report and the report on the implementation of
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
19
article 12 of the 1988 Convention. The Board also publishes
technical reports that provide Governments with an analysis
of statistical information on the manufacture, consumption,
utilization and stocks of and trade in internationally con-
trolled substances, together with an analysis of estimates and
assessments of requirements for those substances.
83. The Board’s reports and technical publications are
produced on the basis of information that parties to the
international drug control treaties are obligated to submit.
In addition, pursuant to resolutions of the Economic and
Social Council and the Commission on Narcotic Drugs,
Governments voluntarily provide information in order to
facilitate an accurate and comprehensive evaluation of the
functioning of the international drug and precursor control
system.
84. The data and other information received from
Governments enable the Board to monitor licit activities
involving narcotic drugs, psychotropic substances and pre-
cursor chemicals and to evaluate treaty compliance and the
overall functioning of the international drug and precursor
control system. On the basis of its analysis, the Board makes
recommendations to improve the workings of the system
with a view to ensuring the availability of narcotic drugs and
psychotropic substances for medical, scientific and indus-
trial needs, while at the same time preventing their diversion
from licit into illicit channels.
situations, which create additional obstacles to their drug
control efforts, in addition to a general lack of human and
financial resources.
87. Most countries that produce, manufacture, import,
export or consume large amounts of narcotic drugs submit-
ted annual statistics, although of differing quality. Accurate,
complete and timely reporting is an important indicator
of the effectiveness and efficiency of drug control systems,
and the availability of good data is vital for the Board to
accurately carry out the monitoring function accorded to it
under the international drug control treaties. The quality of
some data is a concern for the Board, in particular if they are
data from major producing and manufacturing countries, as
they indicate deficiencies in national mechanisms for regu-
lating and monitoring internationally controlled substances.
The Board urges Governments to continue to strengthen
their national mechanisms to monitor the cultivation, pro-
duction and manufacture of and trade in controlled sub-
stances. This may be achieved, in part, by improving and
developing national data-collection systems, training staff of
the competent national authorities and ensuring close coop-
eration with companies licensed to deal with internationally
controlled substances.
88. As at 1 November 2023, the complete set of four quar-
terly statistics of imports and exports of narcotic drugs for
2022 (form A) had been received from 146 Governments
(135 countries and 11 territories), or about 69 per cent of the
213 Governments requested. In addition, 26 Governments
(about 12 per cent) had submitted at least one quarterly
report. A total of 41 countries (about 19 per cent) had failed
to submit any quarterly statistics for 2022.
Narcotic drugs
85. As at 1 November 2023, the Board had received annual
statistical reports from 155 States (both parties and non-
parties) and territories on the production, manufacture,
consumption, utilization, stocks and seizures of narcotic
drugs covering the calendar year 2022 (form C), or about
72 per cent of those requested. That number was slightly
lower than the number of reports for 2021 received by 7
September 2022.
86. A total of 117 Governments, or 45 per cent of all
Governments providing data, submitted their statistical
forms on time, that is, by the deadline of 30 June 2023,
which was fewer than in 2022 (121 Governments). As at
1 November 2023, 59 Governments (28 per cent) had not
submitted their annual statistics for 2022. It is expected that
several additional countries and territories will be submit-
ting their data over the coming months. Of the countries
and territories that have not submitted their reports, the
majority are in Africa and the Americas (including the
Caribbean), followed by Asia and Oceania; two European
countries have not provided their annual statistical form.
Some of those countries are in conflict and post-conflict
Psychotropic substances
89. The number of annual statistical reports on psycho-
tropic substances submitted for 2022 (form P), in accord-
ance with article 16 of the 1971 Convention, increased in
comparison with the number submitted for the previous
year. As at 1 November 2023, annual statistical reports for
2022 had been submitted by 154 countries and 13 territories.
Of the 184 States parties to the 1971 Convention, 149 States
parties, or 81 per cent, had submitted their annual statistical
reports; and 100, or 67 per cent, of those 149 States par-
ties had submitted their reports by the 30 June deadline. A
small number of States parties continued to submit statistics
through partner countries. Furthermore, the Board received
annual statistics from four States that are not parties to the
Convention but that submit national data on a voluntary
basis. Additionally, for the first time, the Board obtained
the annual statistics from San Marino, the statistical data of
which had previously been included in those of Italy.
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INCB REPORT 2023
90. In addition, 113 Governments voluntarily sub-
mitted all four quarterly statistical reports for 2022 on
imports and exports of substances listed in Schedule II of
the 1971 Convention, as requested by the Economic and
Social Council in its resolution 1981/7, and a further 31
Governments submitted at least one quarterly report for
2022. The Board notes with satisfaction the good rate of
submission of the annual statistical reports on psychotropic
substances for 2022 and the number of non-parties and ter-
ritories that have submitted an annual report.
91. The Board notes with concern the high percentage of
States parties that did not furnish form P. A total of 19 coun-
tries and territories in Africa failed to furnish form P for 2022.
Likewise, 10 countries and territories in Oceania, 8 countries
and territories in Asia, 8 countries in Central America and
the Caribbean, 2 countries in Europe and 1 country in South
America failed to furnish form P for 2022. Form P for 2022
was furnished by all countries in North America.
92. The Board takes note of the countries that have pro-
vided data regarding their use of psychotropic substances
for the manufacture of preparations exempted from some
measures of control pursuant to article 3 of the 1971
Convention: 12 countries reported using 37 substances for
such purposes in 2022.
The Board recalls recommenda-
tion 13 of its annual report for 2019,
113
in which it called
upon Governments to ensure that all aspects of article 3 of
the 1971 Convention were correctly implemented if they
wished to exempt a preparation from certain measures
of control.
93. The Economic and Social Council, in its resolutions
1985/15 and 1987/30, requested Governments to provide the
Board with details on trade (data broken down by country
of origin and destination) in substances listed in Schedules
III and IV of the 1971 Convention in their annual statistical
reports on psychotropic substances. As at 1 November 2022,
complete details on such trade had been submitted by 152
Governments (91 per cent of all submissions of form P for
2022). A further 15 Governments submitted blank forms or
forms containing incomplete trade data for 2022.
94. The Board notes with appreciation that a number
of countries have already submitted consumption data for
psychotropic substances on a voluntary basis, in accordance
with Commission on Narcotic Drugs resolution 54/6.
95. For 2022, a total of 99 countries and territories submit-
ted data on the consumption of some or all psychotropic
substances. The Board appreciates the cooperation of the
Governments concerned and calls upon all Governments
113
to report on the consumption of psychotropic substances on
an annual basis, pursuant to Commission on Narcotic Drugs
resolution 54/6, as such data are essential for an improved
evaluation of the availability of psychotropic substances for
medical and scientific purposes.
96. The Board notes with appreciation that reports on
seizures of psychotropic substances were furnished by the
Governments of Algeria, India and Iran (Islamic Republic
of).
The Board acknowledges the interdiction efforts of
the Governments concerned and reiterates its call for
all Governments to furnish directly to the Board any
information on interdictions of attempted diversions
of psychotropic substances and keep it appraised of any
developments in their trafficking.
Precursor chemicals
97. In accordance with article 12 of the 1988 Convention,
parties are obliged to furnish information on substances
frequently used in the illicit manufacture of narcotic drugs
and psychotropic substances. That information, provided
on form D, assists the Board in monitoring and identifying
trends in trafficking in precursors and the illicit manufacture
of drugs. It also enables the Board to provide Governments
with recommendations concerning remedial action and
policies, as necessary.
98. As at 1 November 2023, a total of 114 Governments,
including about 60 per cent of the States parties to the 1988
Convention, had submitted form D for 2022. However, the
Board’s analysis of the global precursor situation contin-
ued to be affected by late submission, the submission of
incomplete or entirely blank forms, and the inability of some
Governments to gather information at the national level and
consolidate it into a single submission. For example, of the
States parties that provided data on form D for 2022, only
68 reported the mandatory information on seizures of sub-
stances listed in Table I or Table II of the 1988 Convention,
and only 56 reported seizures of non-scheduled substances.
The level of the provision of details on the methods of diver-
sion and illicit manufacture remained an issue of concern,
as in previous years.
99. Pursuant to Economic and Social Council resolu-
tion 1995/20, Governments are also requested to provide
information regarding their licit trade in substances listed
in Table I and Table II of the 1988 Convention on a volun-
tary and confidential basis. As at 1 November 2023, 105
States parties had provided such information for 2022 to
the Board, and 91 had furnished data on licit uses of and/
or requirements for one or more of the substances listed in
Tables I and II of the 1988 Convention.
E/INCB/2019/1, para. 806.
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
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100. Information shared through the Board’s Precursors
Incident Communication System (PICS) continued to com-
plement the aggregated seizure data received annually from
Governments through form D. Specifically, the real-time
communication of information on individual chemical and
equipment-related incidents has provided concrete leads for
national authorities to initiate backtracking investigations
and cooperation to identify those responsible for diversion
and trafficking.
101. As at 1 November 2023, PICS had registered users
from more than 300 agencies in 130 countries. They shared
almost 500 new incidents during the reporting period.
102. The seizure data reported and a detailed analysis of
the latest trends and developments in trafficking in precur-
sor chemicals under international control, as well as their
non-scheduled substitutes and alternatives, can be found in
the report of the Board for 2023 on the implementation of
article 12 of the 1988 Convention.
114
104. Governments are obliged to comply with the limits
on imports and exports of narcotic drugs provided for under
articles 21 and 31 of the 1961 Convention as amended.
Article 21 stipulates, inter alia, that the total of the quantities
of each drug manufactured and imported by any country
or territory in a given year is not to exceed the sum of the
following:
(a)
the quantity consumed for medical and sci-
entific purposes;
(b)
the quantity used, within the limits of
the relevant estimates, for the manufacture of other drugs,
preparations in schedule III and of substances not covered
by the 1961 Convention;
(c)
the quantity exported;
(d)
the
quantity added to the stock for the purpose of bringing that
stock up to the level specified in the relevant estimate; and
(e)
the quantity acquired within the limit of the relevant esti-
mate for special purposes. Article 31 requires all exporting
countries to limit the export of narcotic drugs to any coun-
try or territory to quantities that fall within the limits of the
total of the estimates of the importing country or territory,
with the addition of the amounts intended for re-export.
105. The system of imports and exports continues to be
implemented by Governments without major challenges.
In 2023, a total of 15 countries were contacted regarding
possible excess imports or excess exports identified with
regard to international trade in narcotic drugs that had been
effected during 2022. As at 1 November 2023, five of those
countries had responded. The Board continues to pursue
the matter with those countries that have not responded.
(b) Estimates for narcotic drugs,
assessments for psychotropic substances
and annual legitimate requirements for
precursor chemicals
Narcotic drugs
103. The estimates of annual legitimate requirements for
narcotic drugs and the assessments of annual legitimate
requirements for psychotropic substances are essential pil-
lars of the international drug control system. They enable
both exporting and importing countries to ensure that trade
in those substances stays within the limits determined by
the Governments of importing countries and that diver-
sion of controlled substances from international trade is
effectively prevented. For narcotic drugs, the estimates of
annual legitimate requirements are mandatory under the
1961 Convention as amended, and the estimates furnished
by Governments need to be confirmed by the Board before
becoming the basis for calculating the limits on manufacture
and import. As at 20 November 2023, the Governments
of 177 countries and territories, or 82.7 per cent of those
requested, had submitted estimates of requirements for
narcotic drugs for 2024. To ensure that Governments may
import narcotic drugs for medical and scientific purposes,
estimates are established by the Board for countries that are
unable to supply them. In 2023, a total of 39 countries, in
all regions of the world, operated on the basis of estimates
established for them by the Board.
114
Psychotropic substances
106. Pursuant to Economic and Social Council resolutions
1981/7 and 1991/44, Governments are requested to provide
to the Board assessments of annual domestic medical and
scientific requirements for psychotropic substances listed
in Schedules II, III and IV of the 1971 Convention. The
assessments received are communicated to all States and
territories to assist the competent authorities of exporting
countries when approving exports of psychotropic sub-
stances. As at 1 November 2023, the Governments of all
countries and territories except South Sudan (for which
assessments were established by the Board in 2011) had
submitted at least one assessment of their annual medical
requirements for psychotropic substances.
107. However, 60 Governments have not submitted a full
revision of their legitimate requirements for psychotropic
substances for three years or more. The assessments valid
for those countries and territories may therefore no longer
reflect their actual medical and scientific requirements for
such substances.
E/INCB/2023/4.
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INCB REPORT 2023
108. When assessments are lower than the actual legiti-
mate requirements, the importation of psychotropic sub-
stances needed for medical or scientific purposes may be
delayed. When assessments are significantly higher than
legitimate needs, the risk of psychotropic substances being
diverted into illicit channels may be increased.
109. As in previous years, the system of assessments of
annual requirements for psychotropic substances contin-
ues to function well and is respected by most countries and
territories. In 2022, the authorities of 18 countries issued
import authorizations for substances for which they had
not established any such assessments or for quantities that
significantly exceeded their assessments. No country was
identified as having exported psychotropic substances in
quantities exceeding the relevant assessment.
110.
The Board recommends that Governments continue
to strengthen the capacity of competent national authori-
ties to adequately estimate their medical and scientific
requirements for narcotic drugs and assessments for psy-
chotropic substances, including through the use of globally
available e-learning modules, and also recommends that
Governments enhance domestic data-collection mecha-
nisms so that they can present estimates and assessments
that reflect the national requirements used for medical pur-
poses. The Board further recommends that Governments
review and update the assessments of their annual medical
and scientific requirements for psychotropic substances at
least once every three years.
or updated their annual legitimate requirements for at least
one substance.
113. Governments provide estimates of their annual legiti-
mate requirements for imports of precursors of amphetamine-
type stimulants and their preparations to the Board mostly
on form D and can update them at any time throughout
the year by means of individual communications. The latest
annual legitimate requirements, as submitted by countries
and territories, are regularly updated and published on a
dedicated page of the Board’s website. Annual legitimate
requirements are also available to registered users through
the PEN Online system.
114. Further details related to annual legitimate require-
ments can be found in the report of the Board for 2023 on
the implementation of article 12 of the 1988 Convention.
In addition, the publication entitled
Guide on Estimating
Requirements for Substances under International Control,
developed by INCB and WHO for use by competent
national authorities, and the document entitled “Issues that
Governments may consider when determining annual legit-
imate requirements for imports of ephedrine and pseudo-
ephedrine” are available on the Board’s website.
4. Efforts to prevent diversion from
international trade
115. The system of control measures laid down in the
1961 Convention as amended provides for the monitor-
ing of international trade in narcotic drugs to prevent the
diversion of such drugs into illicit channels. As a result of
the almost universal implementation of the control meas-
ures stipulated in the 1971 Convention and the relevant
Economic and Social Council resolutions, there has been
only one identified case involving the diversion of psy-
chotropic substances from international trade into illicit
channels in recent years. In addition, the 1988 Convention
requires parties to prevent the diversion of precursor chemi-
cals from international trade to the illicit manufacture of
narcotic drugs and psychotropic substances. The Board has
developed various systems to monitor compliance with that
aspect of the 1988 Convention and to facilitate cooperation
between Governments to that end.
Precursor chemicals
111. In the context of Commission on Narcotic Drugs res-
olution 49/3, Member States voluntarily provide estimates of
their annual legitimate requirements for imports of certain
precursor chemicals frequently used in the illicit manu-
facture of amphetamine-type stimulants. The provision of
annual legitimate requirements is requested for ephedrine,
pseudoephedrine, 3,4-MDP-2-P and P-2-P, as well as, to the
extent possible, preparations containing those substances
that could be easily used or recovered by readily applica-
ble means. The estimates are aimed at informing exporting
countries about the legitimate requirements of importing
countries for those substances, thus preventing their over-
supply and diversion into illicit channels and ensuring their
availability for legitimate purposes.
112. As at 1 November 2023, 185 Governments had pro-
vided an estimate of their annual legitimate requirement for
at least one of the above-mentioned precursor chemicals.
During the reporting period, 105 Governments reconfirmed
Requirement for import and export
authorizations
116. The universal application of the requirement for
import and export authorizations laid down in the 1961
Convention as amended and the 1971 Convention is key
to preventing the diversion of drugs into the illicit market.
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
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Such authorizations are required for transactions involving
any of the substances controlled under the 1961 Convention
as amended or listed in Schedules I and II of the 1971
Convention.
117. Competent national authorities are required by
those conventions to issue import authorizations for trans-
actions involving the importation of such substances into
their country. The competent national authorities of export-
ing countries must verify the authenticity of such import
authorizations before issuing the export authorizations
required to allow shipments containing the substances to
leave their countries. Information on the use of electronic
import and export authorizations for trade in internationally
controlled narcotic drugs and psychotropic substances is
provided in paragraphs 308–314 of the present report.
118. The 1971 Convention does not require import
and export authorizations for trade in the psychotropic
substances listed in its Schedules III and IV. However, in
view of the widespread diversion of those substances from
licit international trade during the 1970s and 1980s, the
Economic and Social Council, in its resolutions 1985/15,
1987/30 and 1993/38, requested Governments to extend the
system of import and export authorizations to cover those
psychotropic substances as well.
119. Most countries and territories have already intro-
duced an import and export authorization requirement
for psychotropic substances listed in Schedules III and IV
of the 1971 Convention, in accordance with the above-
mentioned Economic and Social Council resolutions. As
at 1 November 2023, specific information had been made
available to the Board by 205 countries and territories,
showing that all major importing and exporting countries
and territories now require import and export authoriza-
tions for all psychotropic substances listed in Schedules III
and IV of the 1971 Convention. Upon request, the Board
will make available, to all Governments, a table showing the
import authorization requirements for substances listed in
Schedules III and IV pursuant to the relevant Economic and
Social Council resolutions. That table is also published in
the secure area of the Board’s website, which is accessible
only to specifically authorized government officials, so that
the competent national authorities of exporting countries
may be informed as soon as possible of changes in import
authorization requirements in importing countries.
120.
The Board reiterates its call to the Governments
of the few remaining States in which national legisla-
tion and/or regulations do not yet require import and
export authorizations for all psychotropic substances,
regardless of whether they are States parties to the 1971
Convention, to extend such controls to all substances
listed in Schedules III and IV of the 1971 Convention as
soon as possible and to inform the Board in that regard.
Discrepancies in international trade in
narcotic drugs and psychotropic substances
121. Discrepancies in government reports on inter-
national trade in narcotic drugs and psychotropic substances
are regularly investigated with the competent authorities of
the relevant countries to ensure that no diversion from licit
international trade has taken place. Those investigations
may reveal shortcomings in the implementation of control
measures, including the failure of companies to comply with
national drug control provisions.
122. Since June 2023, investigations regarding discrepan-
cies for 2022 related to international trade in narcotic drugs
have been initiated with 54 countries. As at 1 November
2023, replies had been received from 27 countries. The
responses indicated that the discrepancies had been caused
by clerical and technical errors in preparing the reports,
reporting on exports or imports of preparations in Schedule
III of the 1961 Convention as amended without indicating
it on the form, or inadvertent reporting of transit countries
as trading partners. In some cases, countries confirmed the
quantities reported by them, resulting in the initiation of
follow-up investigations with their trading partners. The
Board encourages the countries that have not yet replied to
investigate the discrepancies as a matter of urgency and to
inform it of their findings.
123. Similarly, with regard to the international trade
in psychotropic substances, investigations relating to
data quality concerns for 2021 data were initiated with
111 Governments, out of which 53 Governments have
responded. As at 1 November 2023, discrepancies involv-
ing 106 countries and territories were identified with regard
to 2022 annual statistical data.
Pre-export notifications for precursor
chemicals
124. The submission of pre-export notifications by export-
ing authorities to importing countries and territories has
proved to be the most effective tool to quickly verify the
legitimacy of individual transactions and identify suspi-
cious shipments. Article 12, paragraph 10 (a), of the 1988
Convention allows the Governments of importing coun-
tries to make it mandatory for exporting countries to inform
them of any planned export of internationally controlled
precursors to their territory. Since the publishing of the
annual report of the Board for 2022, the Government of
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INCB REPORT 2023
Burkina Faso has officially requested to be pre-notified of
any planned export of substances included in Tables I and II
of the 1988 Convention to its territory, thus increasing the
number of Governments that have invoked that provision
to 118. The Governments of Belarus and the United States
amended their initial requests to now include all substances
in Table I and Table II of the 1988 Convention, respec-
tively.
The Board encourages all importing Governments
that have not formally requested pre-export notifica-
tions to invoke article 12, paragraph 10 (a), of the 1988
Convention.
125. PEN Online, the secure web-based tool established
by the Board, facilitates real-time communication between
importing and exporting Governments with regard to inter-
national trade in precursors. As at 1 November 2023, the
Government of one more country, Antigua and Barbuda,
had registered with PEN Online, bringing the total number
of registered countries and territories to 169. INCB calls upon
the Governments that have not yet registered with the PEN
Online system to nominate at least one focal point for that
purpose as soon as possible and calls upon Governments to
use PEN Online actively and systematically. The Board stands
ready to assist Governments in that regard.
126. To assist Governments in exchanging information on
the international movement of non-scheduled chemicals,
the Board launched PEN Online Light, a system similar to
PEN Online, in October 2022. Although the sharing of infor-
mation about planned exports of precursor chemicals not
under international control through the PEN Online Light
system is voluntary,
the Board encourages Governments
to use that system for the export of such substances from
their territory. More information on the functioning of
PEN Online and PEN Online Light can be found in the
report of the Board for 2023 on the implementation of
article 12 of the 1988 Convention.
the sharing of operational investigative experience, PICS,
the INCB platform dedicated to sharing information on
seizures of precursor chemicals, also contains information
on seized equipment. The Board’s resources and tools to
help raise awareness, support Governments in increasing
the implementation of article 13 and guide international
policy efforts and cooperation to that end are available on
a dedicated page of the INCB website.
The Board encour-
ages Governments that have not yet implemented arti-
cle 13 of the 1988 Convention to examine ways to do so.
Governments are also encouraged to make full use of
the Board’s available tools and resources related to illicit
manufacturing equipment, including PICS.
128. During the reporting period, the Board contin-
ued to cooperate with WCO to identify currently appli-
cable Harmonized Commodity Description and Coding
System codes (“HS codes”) and establish unique HS codes
for the most relevant items of equipment included in the
International Monitoring List of Equipment used in the
illicit manufacture of drugs.
115
The unique HS codes will
allow more effective monitoring of trade in those items
and thus contribute to preventing their diversion into illicit
channels.
B. Ensuring the availability of
internationally controlled
substances for medical and
scientific purposes
129. In line with its mandate to ensure the availability of
internationally controlled substances for medical and scien-
tific purposes, the Board carries out various activities related
to narcotic drugs and psychotropic substances. This includes
monitoring action taken by Governments, international
organizations and other bodies to support the availability
and rational use of controlled substances for medical and
scientific purposes and providing, through its secretariat,
technical support and guidance to Governments in their
implementation of the provisions of the international drug
control treaties.
130. The data available to INCB confirm the persistent dis-
parities between regions in the consumption of opioid anal-
gesics for the treatment of pain. Almost all such consumption
is concentrated in Western Europe, North America, Australia
and New Zealand. Consumption levels in other regions are
The list includes certain items of equipment that are of inter-
national relevance and for which substantial evidence exists of their use
in the illicit manufacture of narcotic drugs, psychotropic substances, new
psychoactive substances and precursors. It is available on the Board’s
secure website.
115
Article 13 of the 1988 Convention:
materials and equipment used in illicit
drug manufacture
127. Article 13 of the 1988 Convention provides a basis
for Governments to cooperate in preventing equipment for
the illicit production or manufacture of drugs from reaching
illicit laboratories. However, the potential of the article has
not yet been explored to the extent possible. Indeed, law
enforcement operations aimed at dismantling illicit drug
manufacturing laboratories mostly focus on seizing the final
product, illicit drugs, paying little attention to the informa-
tion that seized equipment can provide to investigations.
In order to increase specialized knowledge and promote
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
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often not sufficient to meet the medical needs of the popu-
lation. These regional imbalances are not due to a short-
age of opiate raw materials. Supply has been found to be
more than sufficient to satisfy the demand reported to INCB
by Governments, but it is evident that a large number of
countries may not be accurately reflecting in their reported
demand the actual medical needs of their populations, and
hence the disparity in availability.
131. Regional analysis of the main trends in the con-
sumption of the main opioid analgesics (codeine, dextro-
propoxyphene, dihydrocodeine, fentanyl, hydrocodone,
hydromorphone, ketobemidone, morphine, oxycodone,
pethidine, tilidine and trimeperidine), expressed in S-DDD
per million inhabitants per day (S-DDD
pm
), shows that the
highest consumption of these drugs is in developed coun-
tries in Europe and North America.
132. The regional analysis confirms the persistence of a
global disparity in the consumption of opioid analgesics.
Regional S-DDD
pm
is calculated on the basis of the total
population of the countries reporting consumption and the
overall amounts of opioid analgesics reported as consumed.
In 2022, the reported consumption in some countries in
North America, Oceania and Western and Central Europe
resulted in regional averages of 15,467 S-DDD
pm
for North
America, 9,720 S-DDD
pm
for Western and Central Europe
and 5,327 S-DDD
pm
for Oceania. North America remains
the region with the highest consumption of opioids for pain
management in the world (see figures I and II).
Figure I. Consumption of opioids for pain
management in all regions, expressed in S-DDD per
million inhabitants per day, 2003–2022
S-DDD
pm
35 000
30 000
25 000
20 000
15 000
10 000
5 000
0
Figure II. Consumption of opioids for pain
management in all regions, expressed in S-DDD per
million inhabitants per day, 2003–2022 (semi-
logarithmic scale)
S-DDD
pm
32 805
10 935
3 645
1 215
405
135
45
15
5
03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22
Year
Western and Central Europe
South-Eastern Europe
West Asia
East and South-East Asia
Africa
North America
Oceania
South America
Eastern Europe
Central America and
the Caribbean
South Asia
133. The levels of opioid consumption in North America,
Oceania and Western and Central Europe are far higher
than in all other regions in the world. A general upward
trend in consumption was evident in South-Eastern
Europe until 2018, when it reached 1,415 S-DDDpm, but
it has stabilized at about 1,000 S-DDD
pm
in recent years
(1,271 S-DDD
pm
in 2022). Consumption in South America
had been increasing since 2017, when countries reported
537 S-DDDpm, although after an all-time high level of
1,006 S-DDD
pm
in 2021 it dropped to 520 S-DDD
pm
in
2022. In West Asia, consumption reached a record high
level (737 S-DDDpm) in 2022, up from 509 S-DDD
pm
in
2021. In Eastern Europe, opioid consumption peaked in
2019, totalling 601 S-DDDpm, but in 2021 consumption
decreased to 344 S-DDDpm. However, it surged again in
2022 to 572 S-DDDpm. The Board considers levels of con-
sumption of opioid analgesics in quantities between 100 and
200 S-DDD
pm
to be inadequate, and in quantities of less
than 100 S-DDD
pm
to be very inadequate. In this context,
the average levels of consumption reported in 2022 in East
and South-East Asia (217 S-DDDpm), Central America and
the Caribbean (170 S-DDDpm), Africa (62 S-DDDpm) and
South Asia (16 S-DDDpm) are of particular concern.
134. Figures III and IV show consumption of opioid anal-
gesics in total S-DDD
pm
by substance and region. This
analysis highlights once again the predominance of fentanyl
in most regions of the world. Consumption of oxycodone
is highest in North America, Oceania, Western and Central
Europe and West Asia, although the substance is also
03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22
Year
Western and Central Europe
South-Eastern Europe
West Asia
East and South-East Asia
Africa
North America
Oceania
South America
Eastern Europe
Central America and
the Caribbean
South Asia
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INCB REPORT 2023
consumed in other regions. Hydrocodone consumption is
significant in the Americas. The share of morphine con-
sumption is less pronounced in most regions with the lowest
consumption levels, except for South America and South-
Eastern Europe.
135.
The Board reiterates that there is an urgent need to
increase the availability of and access to opioid analgesics
and to improve their prescription and use, especially in
countries reporting inadequate and very inadequate levels
of consumption, and calls for targeted public policies
supported by Governments, health systems and health
professionals, civil society, the pharmaceutical industry
and the international community.
of the global medicine supply chain. The consolidated sta-
tistics on narcotic drugs for 2022 suggest a potential return
to pre-pandemic levels for most indicators.
137. Analysis of the consumption of opioid analgesics,
as reported by Governments to the Board, reaffirmed the
persistent issue of unequal access to and affordability of
opioid analgesics, such as morphine. A significant portion
of the morphine produced worldwide is utilized for other
purposes. In 2022, 9.9 per cent of the morphine available
globally (quantities manufactured and opening stocks) was
consumed directly, primarily for palliative care, an increase
from the previous decade. However, of that 9.9 per cent,
only a fraction (13.9 per cent) was made available to a large
portion of the global population (80.2 per cent), primarily
residing in low- and middle-income countries.
138. The consumption of morphine, along with other
opioid analgesics, remains concentrated in developed coun-
tries in Europe and North America, and levels of consump-
tion in other regions remain insufficient to adequately address
the medical needs of their populations (see figure V). Another
cause for concern is the continued decline in morphine pro-
duction in 2022, a trend that commenced in 2015.
139. This imbalance does not stem from a shortage of
opiate raw materials. Apart from opium, the production of
which has been declining for several years, overall utilization
Figure IV. Consumption of codeine,
a
fentanyl,
hydrocodone, morphine, oxycodone, pethidine and
other opioids, by regions with lowest consumption,
expressed in S-DDD
pm
, 2022
Africa
Central America and the Caribbean
East and South-East Asia
Eastern Europe
South America
South Asia
South-Eastern Europe
West Asia
1.
Patterns and trends in the
production, manufacture,
consumption, utilization and stocks
of narcotic drugs and psychotropic
substances
Narcotic drugs
136. In 2021, owing to the COVID-19 pandemic, coun-
tries stockpiled certain substances, in particular fentanyl
analogues, in response to concerns regarding the stability
Figure III. Consumption of codeine,
a
fentanyl,
hydrocodone, morphine, oxycodone, pethidine and
other opioids, all regions, expressed in S-DDD
pm
,
2022
Africa
Central America and the Caribbean
East and South-East Asia
Eastern Europe
North America
Oceania
South America
South Asia
South-Eastern Europe
West Asia
Western and Central Europe
0
Fentanyl
Codeine
a
5 000
Morphine
Others
10 000 15 000 20 000
S-DDD
pm
Hydrocodone
0
Fentanyl
Codeine
a
200 400 600 800 1 000 1 200 1 400
S-DDD
pm
Morphine
Others
Hydrocodone
Oxycodone
Pethidine
Oxycodone
Pethidine
Only codeine used directly for pain relief is considered. Codeine used for
preparations included in Schedule III is excluded.
Only codeine used directly for pain relief is considered. Codeine used for
preparations included in Schedule III is excluded.
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Figure V. Morphine: distribution of consumption in
relation to the share of the world population, 2022
Australia and
New Zealand
(0.5%)
6.4%
Canada
(0.6%)
6.6%
Japan
(2%)
0.5%
Other countries
(80.2%)
13.9%
140. Global production of thebaine increased in 2022,
while its utilization decreased. This trend was evident from
the production of various semi-synthetic opioids derived
from thebaine. The manufacture of oxycodone continued
to decline in 2022, while consumption of the substance
remained relatively stable. In addition, consumption of
hydromorphone remained steady, but its production
increased in 2022. Notably, consumption of hydromor-
phone was predominantly confined to the United States
and remained stable, despite a decrease in its manufacture.
141. Among synthetic opioids, global manufacture of fen-
tanyl decreased by half in 2022 compared with 2021, and
consumption of the substance also declined (see figure VI).
This downward trend could be attributed to ongoing con-
cerns about overdose deaths linked to the misuse of fentanyl
and similar substances.
United States
(5.2%)
33.1%
Europe
(11.5%)
39.5%
Note:
Percentages in parentheses refer to share of the total population of
all reporting countries worldwide.
of poppy straw and concentrate of poppy straw derived from
both morphine-rich and thebaine-rich varieties remained
high in 2022, with stocks increasing. This suggests that
the supply exceeds the demand, even though the demand
expressed by several countries may not accurately reflect the
actual medical needs of their populations.
142.
The licit cultivation, production and utilization of
cannabis have grown significantly since 2000, when more
countries worldwide began employing cannabis and can-
nabis extracts for medical purposes and scientific research
(see figure VII). Over the past 20 years, global cannabis
production has consequently surged, reaching 797 tons in
2022. Given the substantial increase in the licit cultivation of
cannabis plants for medical and scientific purposes in recent
years, along with variations in yield and manufacturing pro-
cesses, certain data are being clarified in collaboration with
the relevant Governments to ensure consistency.
Figure VI. Fentanyl: global manufacture,
consumption and stocks,
a
2003–2022
Tons
6
5
4
3
2
1
0
Figure VII. Cannabis: global production,
consumption and stocks,
a
2003–2022
Tons
3 000
2 500
2 000
1 500
1 000
500
0
03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22
Year
Stocks
Manufacture
Consumption
a
03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22
Year
Stocks
Production
Consumption
a
Stocks as at 31 December of each year.
Stocks as at 31 December of each year.
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INCB REPORT 2023
143. In 2021, the Plurinational State of Bolivia reported
the production of 24,960 tons of coca leaf, derived from
the licit cultivation of coca bush. Meanwhile, Peru did not
report production figures for 2022, but did report the export
of 76 tons of coca leaf. Despite these figures, the global licit
manufacture and consumption of cocaine continued to
decrease, reaching the lowest levels in two decades.
Psychotropic substances
144. At the end of 2022, a total of 167 psychotropic sub-
stances were under international control, up from 166 at
the end of 2021. Eutylone came under international control
in November 2022 and was included by the Commission
on Narcotic Drugs in Schedule II of the 1971 Convention.
145. A total of 1,049.3 tons of psychotropic substances
under international control were manufactured in 2022. Of
that quantity, 863.8 tons were sedatives, 160.3 tons were
stimulants and 25.2 tons comprised hallucinogens, analge-
sics and other substances. With respect to specific sub-
stances, as can be seen in figure VIII, 10 psychotropic
substances accounted for approximately 80 per cent of total
global manufacture by gross weight in 2022. All other psy-
chotropic substances combined made up about 20 per cent
of overall manufacture in 2022.
146. At 364.3 tons, phenobarbital was the most heavily
manufactured internationally controlled psychotropic sub-
stance in 2022. Meprobamate was the second most heavily
manufactured, at 97.1 tons, followed by methylphenidate
(64.5 tons), pentobarbital (56 tons), GHB (51.9 tons), barbital
(48.7 tons), dexamfetamine (40 tons), diazepam (39.6 tons),
zolpidem (39.1 tons) and phentermine (29.1 tons).
147. With regard to the primary manufacturers of inter-
nationally controlled psychotropic substances, figure IX
shows that five countries were responsible for more than
85 per cent of all global manufacture in 2022: China (35 per
cent, or 363.2 tons), India (21 per cent, or 221.1 tons),
United States (17 per cent, or 178.9 tons), Italy (9 per cent,
or 91.7 tons) and Germany (5 per cent, or 55.2 tons). All
other countries and territories combined were responsible
for 13 per cent (139.1 tons) of global manufacture.
Figure IX. Shares of total manufacture of
internationally controlled psychotropic substances
by gross weight, 2022
Other countries
and territories
13%
Germany
5%
Italy
9%
China
35%
2022
United States
of America
17%
India
21%
Figure VIII. Shares of manufacture of major
internationally controlled psychotropic substances
by gross weight, 2022
148. With regard to international trade, seven benzo-
diazepines were among the most widely traded psychotropic
substances in 2022 (see table below). Phenobarbital was the
most widely traded barbiturate under international control,
while methylphenidate was the most widely traded stimu-
lant. Zolpidem was the most traded non-benzodiazepine
non-barbiturate sedative. More than 158 countries and terri-
tories reported imports of diazepam. Imports of midazolam,
phenobarbital and alprazolam were reported by 140 to
150 countries and territories.
149. With regard to the consumption of psychotropic sub-
stances, 99 countries and territories provided data regard-
ing the consumption of at least one substance in 2022, a
slight increase from the 96 countries and territories that
provided such data in 2021. Reporting rates at the regional
level varied widely; data on consumption in 2022 were pro-
vided by 16 countries and territories in Africa (28 per cent of
the total number of countries and territories in the region),
25 countries and territories in the Americas (56 per cent),
Meprobamate
Methylphenidate
Pentobarbital
Barbital
Dexamfetamine
Zolpidem
Phenobarbital
Other substances
GHB
Diazepam
Phentermine
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
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Table. Most widely traded internationally
controlled psychotropic substances, 2022
Substance
Diazepam
Midazolam
Phenobarbital
Alprazolam
Clonazepam
Lorazepam
Zolpidem
Methylphenidate
Bromazepam
Clobazam
Total imports (kg)
44 929.92
14 541.02
205 429.06
9 618.90
14 990.60
8 882.25
38 198.80
52 513.10
12 617.66
7 457.22
Number of importing
countries and territories
158
150
148
140
135
129
117
115
108
91
153. Methylphenidate is the most widely traded stimu-
lant among the psychotropic substances under international
control. Global manufacture of methylphenidate decreased
from 71.3 tons in 2021 to 64.5 tons in 2022. The number of
importing countries and territories also dropped slightly,
from 118 in 2021 to 115 in 2022. At the same time, the
worldwide volume of imports of the substance fell from
63.8 tons in 2021 to 52.5 tons in 2022.
154. A total of 62 countries provided data on methyl-
phenidate consumption in 2022, with some countries
reporting a considerable reduction in consumption of the
substance. Compared with the figures reported for 2021,
the consumption of methylphenidate decreased consider-
ably in Iceland, from 53.33 S-DDD
pt
to 29.47 S-DDD
pt
;
nevertheless, the country reported the highest consumption
worldwide in 2022. The consumption of methylphenidate
in Canada, Denmark, Netherlands (Kingdom of the) and
Sweden increased slightly in 2022. While the consump-
tion of the substance decreased in Israel and the United
States, Guatemala reported a significant increase, from
0.01 S-DDD
pt
in 2021 to 4.87 S-DDD
pt
in 2022.
155. Like diazepam and phenobarbital, zolpidem is one
of the most widely traded psychotropic substances under
international control. In 2022, 122 countries and territo-
ries reported imports of the substance, and consumption
of zolpidem was reported in all regions of the world. The
manufacture of zolpidem rose from 38.2 tons in 2021 to
39.1 tons in 2022.
156. The number of countries and territories providing
data on consumption of the substance rose from 63 in 2021
to 64 in 2022. In 2022, Uruguay reported the highest level
of consumption of zolpidem worldwide, at 23.82 S-DDD
pt
,
followed by Portugal at 19.16 S-DDD
pt
. Overall, among the
countries that provided data, the average consumption of
zolpidem in Europe was significantly higher than in other
regions.
20 countries and territories in Asia (41 per cent), 32 coun-
tries and territories in Europe (74 per cent) and 6 countries
and territories in Oceania (27 per cent).
150. Diazepam was the most manufactured benzo-
diazepine in 2022 in terms of gross weight, at 39.6 tons,
accounting for 23 per cent of all benzodiazepines with a
significant presence on the licit market. Diazepam was
also the most widely traded internationally controlled psy-
chotropic substance in 2022, with 158 countries reporting
imports of the substance. The global average consump-
tion of diazepam among countries that provided data has
been declining, from a high of 2.67 S-DDD
pt
in 2019 to
2.01 S-DDD
pt
in 2022. Similarly, the number of countries
providing consumption data has been declining since 2020,
with 91 countries providing data in that year to 85 countries
providing data in 2022.
151. In terms of gross weight, phenobarbital has been the
most heavily manufactured psychotropic substance under
international control since 2012. In 2022, total reported
manufacture of the substance was 364.3 tons, up signifi-
cantly from the 262.9 tons reported in 2021. Imports of
phenobarbital were reported by 148 countries and territo-
ries in 2022, making the substance one of the most widely
traded psychotropic substances under international control.
In 2022, the total volume of global imports was 205.4 tons,
up slightly from 189 tons in 2021.
152. The number of countries and territories providing
data on phenobarbital consumption increased from 71 in
2021 to 83 in 2022. Among the countries and territories that
provided data, Brazil reported the highest level of phenobar-
bital consumption in 2022 (4.95 S-DDD
pt
), albeit at a lower
level than in 2021 (5.23 S-DDD
pt
).
2.
Supply of and demand for opiate
raw materials
157. The Board, in fulfilment of the functions assigned to
it under the 1961 Convention as amended and the relevant
resolutions of the Economic and Social Council and the
Commission on Narcotic Drugs, regularly examines issues
affecting the supply of and the demand for opiates for licit
requirements and endeavours to ensure a standing balance
between that supply and demand.
158. The Board analyses the data provided by Govern-
ments on opiate raw materials and opiates manufactured
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INCB REPORT 2023
from those raw materials to establish the status of the supply
of and the demand for opiate raw materials globally. In addi-
tion, the Board analyses information on the use, estimated
consumption for licit use and stocks of those raw materials
at the global level. A detailed analysis of the current situation
as it pertains to the supply of and the demand for opiate raw
materials is contained in the technical report of the Board
for 2023 on narcotic drugs.
116
Cultivation, production and stocks
159. The combined total area cultivated with opium poppy
varieties rich in morphine, thebaine, codeine and oripavine
in 2022 declined by one third compared with 2021, with a
decrease in production in almost all major producing coun-
tries. However, while the production of opiate raw materi-
als rich in morphine decreased, the production of opiate
raw materials rich in thebaine increased. With regard to
demand for and stocks of raw materials, a different trend
was registered. In 2022, demand for and stocks of opiate raw
materials rich in morphine increased, but demand for and
stocks of opiate raw materials rich in thebaine decreased.
Regardless of these reductions in the cultivation and pro-
duction of opiate raw materials, their supply remained more
than sufficient to cover the global demand as expressed by
countries in their reporting to the Board for 2023 and 2024.
160. Cultivation of noscapine-rich opium poppy for the
purpose of opiate production in 2022 was reported only in
the planning phase, by Australia and France, and not in those
countries’ reporting on cultivation and harvest. Consequently,
the countries did not report any extraction of the morphine
alkaloid from noscapine-rich opium poppy in 2022.
161. Even though noscapine is not under international
control, a significant amount of morphine can be extracted
from opium poppy rich in noscapine.
For the purposes
of controlling the production of morphine, the Board
requests the countries that cultivate opium poppy rich
in noscapine to provide information in a consistent and
regular manner about the cultivation of this variety, its
intended use and to report to the Board on any extraction
and use of the morphine alkaloid from it.
162. While there was an overall decline in the area under
cultivation with opium poppy for the extraction of alkaloids
in 2022, India and Spain both saw an increase in the cultiva-
tion of morphine-rich opium poppy. India, which is the only
opium-producing country included in the present analysis,
also began to cultivate opium poppy for the production of
poppy straw, which led to an increase in its stocks in 2022.
116
Türkiye significantly reduced its cultivation and production
but remained a holder of large stocks. Australia and Spain
remained the leading producers of raw materials rich in
morphine in 2022 and the only producers of codeine- and
oripavine-rich opium poppy, while Australia was the sole
producer of opium poppy rich in thebaine. Hungary and
Slovakia halted cultivation of opium poppy for the extrac-
tion of alkaloids in 2022, and France maintained similar
levels of cultivation but significantly increased its produc-
tion of raw materials rich in morphine.
163. The total production of opiate raw materials rich in
morphine amounted to 304 tons in 2022, a decline com-
pared with the 329 tons produced in 2021. The total produc-
tion of opiate raw materials rich in thebaine increased to
187 tons in 2022 compared with 164 tons in 2021. Stocks of
opiate raw materials rich in morphine decreased to 838 tons
in morphine equivalent in 2022, down from 888 tons in
2021, while stocks of opiate raw materials rich in thebaine
decreased from 373 tons to 302 tons in the same period.
Total stocks of opiates expressed in morphine equivalent
amounted to 500 tons, while total stocks of opiates expressed
in thebaine equivalent amounted to 302 tons.
Balance between supply and demand
164. Demand for opiate raw materials rich in morphine
increased from 225 tons to 305 tons in morphine equivalent,
while demand for finished opiates decreased from 280 tons
to 268 tons in morphine equivalent. Inversely, demand for
opiate raw materials rich in thebaine decreased in 2022
compared with 2021, from 122 tons to 105 tons in thebaine
equivalent; however, demand for finished opiates increased
from 104 tons in thebaine equivalent in 2021 to 109 tons
in 2022.
165. On the basis of data reported by Governments, total
stocks of opiates and opiate raw materials are fully sufficient
to cover demand for medical and scientific purposes for
morphine-based opiates for more than a year. The quantity of
stocks expressed in morphine equivalent (838 tons) is suffi-
cient to cover global demand at the expected level for 2023
117
of 321 tons for 31 months, well over the 12 months required
by the Board. The quantity of stocks expressed in thebaine
E/INCB/2023/2.
In order to ensure that supply can cover expected demand for at
least one year in case of unforeseen supply issues, such as crop failure, the
Board assesses stocks at the end of year to calculate whether they are suffi-
cient to cover the projected demand for the following year. For the calcu-
lation, the Board determines the total amount of stocks at the end of the
year and divides that number by the total amount of projected demand,
then multiplies the resulting number by 12 to arrive at the total number
of months for which the stocks would be able cover the following year’s
demand at the projected level.
117
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
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equivalent (302 tons) is sufficient to meet global demand at
the level projected for 2023 of 144 tons for 25 months.
166. Figures X and XI below illustrate the relationship
between production, stocks and demand in the current year
and three preceding years, as well as the data-based projec-
tions for the upcoming two years.
167.
Even though the supply of both morphine-rich
and thebaine-rich opiate raw materials is calculated to be
sufficient to cover the demand for medical and scientific
purposes as expressed by countries, the Board highlights
that there are notable disparities between countries in
the availability of narcotic drugs, owing, among other
reasons, to the issue that many Governments do not accu-
rately estimate their medical needs for opioid analgesics
or have limited access to them. Consequently, and in line
with the provisions and objectives of the 1961 Convention
as amended, the Board emphasizes the importance of
ensuring sufficient availability at the global level and calls
upon countries with greater availability of and access to
opiate raw materials and opiates to assist those coun-
tries with limited access and availability in their efforts
to increase access to and availability of such substances
and raw materials.
C. Overall treaty compliance
1.
Evaluation of overall treaty
compliance
168. By becoming party to the international drug con-
trol conventions, States commit to the adoption of a
series of administrative, legislative and policy measures
aimed at implementing their legal obligations under those
instruments.
169. Such measures include:
(a)
establishing mechanisms
for the monitoring of the licit production and manufacture
of, and trade in, narcotic drugs, psychotropic substances
and precursor chemicals;
(b)
ensuring the availability of
controlled substances for medical and scientific purposes;
(c)
adopting legislation and policy to address drug-related
behaviours, including trafficking and diversion; and
(d) taking
all practicable measures for the prevention of
drug use and for the early identification, treatment, educa-
tion, aftercare and social reintegration of persons affected
by drug use.
170. The legal framework, made up of the three inter-
national drug control conventions, confers broad discretion
Figure XI. Supply of and demand for opiate raw
materials rich in thebaine, in thebaine equivalent,
2019–2024
Tons of thebaine equivalent
600
500
400
300
200
100
0
Figure X. Supply of and demand for opiate raw
materials rich in morphine, in morphine equivalent,
2019–2024
Tons of morphine equivalent
1 600
1 400
1 200
1 000
800
600
400
200
0
2019
2020
2021
2022
Stocks as at 31 December
of previous year
Demand for opiate raw materials
a
2024
b
Year
Production in
current year
2023
a
2019
2020
2021
2022
Stocks as at 31 December
of previous year
Demand for opiate raw materials
a
2024
b
Year
Production in
current year
2023
a
Data for production and demand for 2023 are based on advance data
(dotted line) submitted by Governments.
Data for 2024 are based on estimates (dotted line) submitted by
Governments.
b
Data for production and demand for 2023 are based on advance data
(dotted line) submitted by Governments.
Data for 2024 are based on estimates (dotted line) submitted by
Governments.
b
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INCB REPORT 2023
upon States parties for the adoption of administrative, legis-
lative and policy measures to implement their treaty obliga-
tions that they deem to be best suited to the particularities
of their respective systems and that best correspond to their
established priorities.
171. However, the conventions establish a series of parame-
ters within which such discretion is to be exercised. These
include the limitation of the use of narcotic drugs and psy-
chotropic substances exclusively to medical and scientific pur-
poses, the respect for human dignity and rights, the adequate
provision of controlled substances to meet legitimate medical
needs and the principle of proportionality in the formulation
of criminal justice policy for drug-related offences.
172. The conventions also set forth the responsibilities and
functions of the Board. Article 9, paragraph 4, of the 1961
Convention as amended states that the Board is to endeav-
our to limit the cultivation, production, manufacture and
use of drugs to an amount required for medical and scientific
purposes, to ensure their availability for such purposes and
to prevent illicit cultivation, production and manufacture of
and trafficking in and use of drugs. Article 9, paragraph 5,
of the same Convention provides that the measures taken
by the Board under the Convention shall be those most
consistent with the intent to further the cooperation of
Governments with the Board and to provide the mecha-
nism for a continuing dialogue between Governments and
the Board that will lend assistance to and facilitate effective
national action to attain the aims of the Convention.
173. Although the wording is not identical, and that of
the 1988 Convention is somewhat more restrictive, each
of the three drug control conventions also confers a clear
treaty monitoring function upon the Board. The Board’s
monitoring functions are set out in article 14 of the 1961
Convention as amended, article 19 of the 1971 Convention
and article 22 of the 1988 Convention.
174. As the monitoring body established under the three
drug control conventions, and in keeping with its obliga-
tion to foster cooperation with Governments through active
dialogue, the Board reviews developments in States parties
with the aim of supporting them to implement the conven-
tions by assisting in identifying implementation gaps and
proposing remedial action.
175. The Board’s deliberations are informed by its ongoing
interactions with States parties, including the submission of
information and statistical reports by Governments to the
Board, the exchange of official correspondence and meet-
ings between government representatives and the Board,
the undertaking of country missions by the Board and the
participation of Governments in INCB initiatives.
176. The current chapter contains a selection of the
Board’s appraisals of the drug control situation in selected
countries.
(a) Australia
177. The Board continues to engage in dialogue with the
Government of Australia and notes with appreciation the
consistent cooperation of the authorities, in particular in
providing information on legislative developments in the
Australian Capital Territory and nationwide. In this context,
the Board takes note of the Drugs of Dependence (Personal
Possession) Amendment Act 2022, which was passed in the
Legislative Assembly for the Australian Capital Territory on
20 October 2022.
178. Under the Act, individuals found in possession of
small quantities of specific drugs may, instead of being
subject to a potential prison sentence, be issued a simple
drug offence notice, which can be discharged by paying a
fine or participating in a drug diversion programme assess-
ment and harm reduction session. The Australian Capital
Territory intends to monitor drug trends following the
changes and will review the legislation three years following
its implementation. By introducing these legislative changes,
the Board notes that the Australian Capital Territory is avail-
ing itself of the prerogative granted to States under the inter-
national drug control conventions to apply alternatives to
conviction or punishment for drug-related behaviours of
a lesser gravity, in particular when committed by persons
who use drugs.
179. The Board also takes note of the rescheduling of
psilocybine and MDMA by the Department of Health
and Aged Care from schedule 9 (Prohibited substances) to
schedule 8 (Controlled drugs) within the national Standard
for the Uniform Scheduling of Medicines and Poisons. As
of 1 July 2023, psychiatrists approved under the Authorised
Prescriber scheme by the Therapeutic Goods Administration
have been allowed to prescribe MDMA for post-traumatic
stress disorder and psilocybine for treatment-resistant
depression. For all other uses, psilocybine and MDMA
will remain on schedule 9 of the Standard for the Uniform
Scheduling of Medicines and Poisons.
180. The Board will continue to closely monitor the drug
control landscape in Australia, including with respect to
the implementation of these legislative developments. The
Board values its positive cooperation with the Government
of Australia and looks forward to continuing its close dia-
logue on matters concerning the full and effective imple-
mentation of the drug control conventions.
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
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(b)
Germany
181. During the reporting period, the Board continued
to closely monitor drug developments in Germany and to
engage with the Government on matters related to the legali-
zation of cannabis for non-medical use, as announced by the
country’s coalition Government.
182. The Board has had ongoing discussions with the
authorities in Germany and has taken note of the evolu-
tion of the originally planned control measures following
concerns expressed by the European Commission, in par-
ticular with respect to the provisions on the sale of cannabis
in speciality shops to adults for non-medical purposes.
183. The Board notes that the revised draft legislation,
which is currently under consideration, has moved away
from the immediate establishment of a retail distribution
model to one that would initially permit cultivation of up to
three plants in the home by adults for personal consumption,
as well as cultivation of cannabis in cultivation associations.
The Board takes note of the fact that a further stage provided
for in the draft legislation would be the establishment of
regional pilot projects with commercial supply chains. The
draft bill is to enter the legislative procedure in the second
half of 2023 and is expected to be submitted to the European
Commission for consideration.
184. In its interactions with the Government of Germany,
the Board has reiterated that measures to permit the use of
cannabis for non-medical purposes are inconsistent with
article 4, paragraph (c), of the 1961 Convention as amended,
which requires States parties to take such legislative and
administrative measures as may be necessary, subject to the
provisions of the Convention, to limit the use of narcotic
drugs exclusively to medical and scientific purposes. Article
3, paragraph 1 (a) (i), of the 1988 Convention requires the
criminalization of the production, manufacture, extraction,
preparation, offering, offering for sale, distribution, sale,
delivery on any terms whatsoever, brokerage, dispatch, dis-
patch in transit, transport, importation or exportation of
any narcotic drug or any psychotropic substance contrary
to the provisions of the 1961 Convention as amended or the
1971 Convention. Moreover, article 3, paragraph 1 (a) (ii),
of the 1988 Convention requires the criminalization of the
cultivation of cannabis plant for the purpose of the produc-
tion of narcotic drugs contrary to the provisions of the 1961
Convention as amended.
185. The Board acknowledges the public health measures
taken by Germany, in particular those aimed at ensuring
equal access to health care for all vulnerable population
groups, including those in detention. The Government has
also been undertaking initiatives to make information on
the negative effects of drug use more accessible in order to
increase the uptake of care provision. The Board notes the
efforts made by the Government to address the manufacture
and export of and trafficking in new psychoactive substances
and non-scheduled precursors.
186. The Board values its constructive relationship with the
Government of Germany and looks forward to continuing its
dialogue on matters concerning the implementation of the
country’s commitments under the drug control conventions.
(c) Ghana
187. The Board has continued to monitor drug control
developments in Ghana and takes note of the constitutional
challenge to section 43 of the Narcotics Control Commission
Act, which resulted in the invalidation of provisions that
permitted the cultivation of specific types of cannabis for
medicinal and industrial purposes.
188. On 27 July 2022, the Supreme Court of Ghana
declared section 43 of the Narcotics Control Commission
Act unconstitutional as it violated article 106 of the 1992
Constitution, which lays out the formal requirements of the
legislative process.
189. Section 43 of the Narcotics Control Commission
Act, which amended the relevant provisions of the Narcotic
Drugs Act 1990, provided that a minister could grant a
licence for the cultivation of cannabis with “not more than
0.3 per cent THC content on a dry weight basis for industrial
purposes for obtaining fibre or seed or for medicinal pur-
poses”. In its judgment, the Supreme Court found that the
Parliament had not complied with the mandatory constitu-
tional requirements of the legislative process in passing the
amendment as it had not been published within the required
time frame and its explanatory memorandum did not meet
the conditions required. As a result of those omissions, the
provision was invalidated by the Court.
190. The Board will continue to monitor changes in the
drug control policies of Ghana, including any updates to
the country’s legal framework with respect to the use of
cannabis for medical purposes. The Board encourages the
Government of Ghana to continue its constructive dialogue
with the Board.
(d) Lao People’s Democratic Republic
191. During the period under review, the Board continued
to closely monitor the ongoing developments in the Lao
People’s Democratic Republic and took note of the opium
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INCB REPORT 2023
survey undertaken with UNODC to determine the levels of
cultivation in the country. The Board looks forward to the
results, as this is the first such survey conducted since 2015.
192. The Board takes note of Decision No. 3789 on the
Control of Hemp for Medication and Products, taken by
the Ministry of Health in December 2022. Under the deci-
sion, the use of cannabis sativa L is authorized for medi-
cal purposes. A medical prescription is required for dried
flowers with no more than 1 per cent THC and cannabis-
related products for medical use containing up to 0.2 per
cent THC and at least four times as much non-psychoactive
CBD as THC. Health supplements, cosmetics, beverages and
essential oils containing less than 0.2 per cent THC can be
distributed and used without a medical prescription. All
cannabis-based products must be registered with the Food
and Drug Department.
193. Under Decision No. 3789, companies with approval
from the Ministry of Health and the Ministry of Planning
and Investment may engage in the cultivation, extraction,
production, processing, storage, distribution, utilization,
import, export and transport of cannabis. Pursuing any
cannabis-related activities without such approval remains an
offence under the Law on Narcotics and the Criminal Code.
194. As far as the use of cannabis for medical purposes
is concerned, the Board reminds the authorities of the Lao
People’s Democratic Republic, at is does with all countries
allowing such use of cannabis, of the requirements of the
international drug control treaties pertaining to the con-
trol of cannabis for medical purposes, including articles 23
(establishing national agencies in order to control cultiva-
tion, production and management of the resulting crops)
and 28 (adopting measures to prevent the misuse of, and
illicit traffic in, cannabis leaves) of the 1961 Convention as
amended, as well as the mandatory reporting obligations to
the Board under that Convention.
195. The Board looks forward to continuing to engage
with the Government of the Lao People’s Democratic
Republic to secure an INCB mission to the country to dis-
cuss issues related to the control system for narcotic drugs,
psychotropic substances and precursor chemicals; progress
in securing the mission has thus far been limited.
197. The Board notes with appreciation the contin-
ued work of the United Nations, the Government of the
Philippines and their partners on the implementation of
the United Nations Joint Programme on Human Rights and
notes the participation of the Government of the Philippines
in various activities under the initiative, including those
aimed at strengthening forensic investigative techniques.
198. On the issue of human rights and drug control, the
Board has continued to stress the need to address the alleged
widespread extrajudicial targeting of persons suspected of
drug-related activities in the Philippines and welcomes
the measures taken by the incoming Government to allow
for those allegations to be investigated and the steps taken
towards ensuring accountability for those involved. At the
same time, the Board notes that, given the number of alleged
extrajudicial acts of violence committed against persons
suspected of involvement of drug-related activities, further
action is needed in order for all cases to be investigated and
prosecuted, to ensure justice for victims and their families.
In this connection, the Board has taken note of the resump-
tion in July 2023 of the investigation by the Prosecutor of the
International Criminal Court, which was predicated on the
finding by the Court that investigations and prosecutions
by the national authorities with regard to the alleged crimes
had been insufficient.
199. The Board continues to emphasize that any extraju-
dicial action purportedly taken in pursuit of drug control
objectives is fundamentally contrary to the provisions and
objectives of the three international drug control conven-
tions, as well as to the human rights norms by which all
countries are bound; that all drug control actions by States
should be undertaken in full respect of the rule of law and
due process of law; and that violations by law enforcement
personnel should be impartially and independently investi-
gated, and prosecuted and punished as appropriate.
200. The Board continues to engage in dialogue with the
Government of the Philippines on drug control policies in
the country and continues to actively seek an agreement with
the Government on a country mission, in order to review its
implementation of the three international drug control con-
ventions. The Board notes with concern that, although the
mission has been agreed to in principle by the Government
of the Philippines, almost no progress has been made in the
past several years in planning it further, despite extensive
outreach efforts by the Board. Accordingly, the Board reiter-
ates its call to the Government of the Philippines to facilitate
the holding of the mission at the earliest opportunity.
(e)
Philippines
196. During the period under review, the Board has
continued to closely follow the drug control situation in
the Philippines, in particular since the election of the new
Government.
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(f ) Thailand
201. The Board continues to follow the developments
regarding drug control in Thailand and takes note of several
legislative developments that occurred during the period
under review.
202. The new Narcotics Code has consolidated 24 previ-
ous pieces of legislation into a single law aiming to imple-
ment a health- and human rights-based approach to drug
control and to address prison overcrowding, while focusing
drug use reduction efforts on tackling major drug syndi-
cates, trafficking and the drug supply chain. Through the
Narcotics Code, Thailand aims to ensure proportionate
criminal justice approaches by abolishing minimum manda-
tory punishments for drug offences of a lesser relative grav-
ity and expunging the criminal records of persons who use
drugs who voluntarily undertake drug treatment, thereby
emphasizing rehabilitation and social reintegration.
203. Changes have also been introduced with respect to
the legal status of cannabis under the country’s Narcotics
Code, in which narcotic drugs under national control are
classified into five categories, pursuant to a notification by
the Minister of Health endorsed by the country’s Narcotics
Control Board. In January 2022, pursuant to such a notifica-
tion, cannabis plant was removed from the list of controlled
narcotic drugs under the Narcotics Code, and only sub-
stances containing extracts of cannabis with a THC content
of more than 0.2 per cent by dry weight were listed under
category 5. This measure came into effect in June 2022, fol-
lowing which cannabis-infused drinks, sweets and other
items became available for purchase.
204. The Board notes the information provided by the
Government of Thailand that, while cannabis is no longer
listed under category 5 of the Narcotics Code, controls
remain in place and the use of cannabis plant and its com-
ponents remains regulated by existing legislation.
205. These acts and measures regulate the use of canna-
bis in food, cosmetics and medical products, as well as the
export and import of cannabis and hemp, while preventing
the sale of cannabis to people below the age of 20 and preg-
nant women and discouraging the use of cannabis for non-
medical purposes. The processing, distribution and sale of
cannabis require a licence and commercial advertising and
sale through vending machines and online are prohibited.
206. The Government of Thailand has also informed
the Board that the above-mentioned measures have been
tightened to control and regulate the use of the flowering or
fruiting tops of the cannabis plants, including for traditional
medicinal purposes.
207. The Board notes that the parliament of Thailand is
considering a draft cannabis bill, which is envisaged to pro-
vide a comprehensive and overarching legal framework for
cannabis and its use. The bill passed its first reading in June
2022 and remains on the parliamentary legislative agenda
for further consideration.
208. The Board notes that the control measures governing
the use of cannabis for non-medical purposes remain in
flux within the country and has reiterated to the authori-
ties that article 4, paragraph (c), of the 1961 Convention as
amended requires States parties to take such legislative and
administrative measures as may be necessary to limit the
use of narcotic drugs exclusively to medical and scientific
purposes and that article 3, paragraph 1 (a), of the 1988
Convention requires the criminalization of the production,
manufacture, extraction, preparation, offering, offering for
sale, distribution, sale, delivery on any terms whatsoever,
brokerage, dispatch, dispatch in transit, transport, importa-
tion or exportation of any narcotic drug or any psychotropic
substance contrary to the provisions of the 1961 Convention
as amended or the 1971 Convention, and also requires the
criminalization of the cultivation of cannabis plant for the
purpose of the production of narcotic drugs contrary to the
provisions of the 1961 Convention as amended.
209. The Board also notes that methamphetamine use in
Thailand is reported to have increased significantly during
the period under review, reportedly due to the increase in
illicit drug manufacture in neighbouring Myanmar, flood-
ing the region with an ever-cheaper supply. The Board notes
that, in response to these developments, the Ministry of
Health of Thailand has prepared a draft regulation under
which anyone caught in possession of more than two pills
of methamphetamine would be prosecuted as a drug dealer.
Under current legislation, people caught with up to 15 meth-
amphetamine pills do not face legal action if they agree to
undergo drug treatment.
210. Within its mandate, the Board will continue to closely
monitor the evolving drug control framework in Thailand and
engage in a dialogue with the new Government, in particular
in relation to the legislative developments on cannabis use.
(g) Ukraine
211. While the Board remains concerned about the armed
conflicts currently under way in many different regions of the
world, in the period under review, it continued to monitor the
developments in Ukraine related to drug control, which have
taken place against the backdrop of the continued armed con-
flict with the Russian Federation and the resulting humanitar-
ian emergency affecting the civilian population of Ukraine.
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INCB REPORT 2023
212. The Board notes with grave concern the continuous
targeting of health infrastructure in Ukraine. According to
the WHO Surveillance System for Attacks on Health Care,
during the first year of the conflict, there were nearly 740
attacks on Ukraine that affected health facilities. These
attacks have significantly affected the delivery of health-care
services in the country, as well as the logistics associated
with the provision of medicines and other supplies. Access to
addiction treatment services has also been disrupted, affect-
ing people with substances disorders throughout the country.
The situation is particularly concerning in territories outside
the control of the Government of Ukraine. Following the
abrupt suspension of opioid agonist therapy, treatment has
effectively been interrupted for patients in need.
213. The Board welcomes the ongoing efforts by WHO,
the United Nations and EMCDDA to support Ukrainian
institutions and experts in strengthening their capacity
to identify and respond to drug-related security and
health threats. In the Provinces of Kharkiv, Donetsk and
Zaporizhzhia, 12 United Nations inter-agency humanitar-
ian convoys were able to deliver health kits, trauma supplies
and medicines to treat non-communicable diseases. WHO,
in cooperation with the Ukrainian health authorities, has
put in place data-collection systems and monitoring tools
to assess health-care system resources and the availability
of services. EMCDDA has worked on ensuring continued
access to opioid agonist therapy and HIV medicines by those
in need, in particular those already receiving such treat-
ments in Ukraine. In mid-March, a list of opioid agonist
therapy and antiretroviral therapy sites and national contact
points for refugees was compiled through EMCDDA and
shared through WHO.
214. The Board reminds all Governments that, in acute
emergencies, they may utilize simplified control procedures
for the export, transportation and provision of medicinal
products containing controlled substances. Competent
national authorities may permit the export of medicines
containing narcotic drugs and/or psychotropic substances
in the absence of the corresponding import authoriza-
tions and/or estimates. Urgent deliveries do not need to be
included in the estimates of the receiving country.
215. The Board takes note of the report of the State Bureau
of Investigations of Ukraine on the illicit manufacture and
sale of narcotic and psychotropic substances. According to
the report, the Bureau detected and dismantled an illegal
amphetamine laboratory, in which drugs were being man-
ufactured on a large scale, in Chernivtsi Province. Also
according to the report, criminal investigations have been
initiated into more than 270 cases of trafficking in drugs
and precursors since the outbreak of armed hostilities with
the Russian Federation.
216. The Board will continue to monitor the humanitar-
ian crisis and the impact of armed attacks on the situation
in Ukraine, while pursuing dialogue with Member States
concerning the provision of controlled substances as part of
humanitarian aid. Within its treaty-mandated functions and
responsibilities, the Board calls for the cessation of all attacks
on the health sector in Ukraine and for the urgent provision
of aid to the country’s civilian population to help alleviate
the human pain and suffering caused by the conflict.
(h)
United Kingdom of Great Britain and
Northern Ireland
217. During the period under review, the Board contin-
ued to monitor drug-related developments in the United
Kingdom of Great Britain and Northern Ireland and engage
in constructive dialogue with the Government on all aspects
of the implementation of the international drug control
conventions.
218. The Board notes the decision of the United Kingdom
to deny royal assent to the cannabis legalization bill of
Bermuda on 6 September 2022. The bill had been reserved
for royal assent by the Governor of Bermuda under section
35 (2) of the Constitution of Bermuda. According to a state-
ment by the Governor, the Secretary of State for Foreign,
Commonwealth and Development Affairs had concluded
that the bill, as drafted, was not consistent with the obliga-
tions of the United Kingdom and Bermuda under the 1961
Convention as amended and the 1971 Convention.
219. In February 2023, as part of “From harm to hope:
A 10-year drugs plan to cut crime and save lives”, adopted
in December 2021, the Government of the United Kingdom
announced that 28 local authorities across England would
receive funds totalling 53 million pounds to help people
in drug and alcohol treatment. The funding is aimed at
providing additional housing support, including from spe-
cialist housing case workers, to improve sustainable and
long-term recovery from drug use disorders by facilitating
independent living. Additional funds have been allocated
to 151 local authorities across the country for the creation
of over 50,000 facilities for drug and alcohol treatment and
have been earmarked for a drug innovation fund supporting
community-based projects intended to reduce the recrea-
tional use of drugs.
220. The Board looks forward to continued cooperation
and dialogue with the United Kingdom on the country’s
institutional and legislative framework on drug control.
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2.
Country missions
221. Every year, the Board undertakes missions to States
parties to the international drug control conventions aimed
at engaging with national drug control stakeholders on their
experiences in the implementation of their obligations
under the three international drug control conventions.
222. Discussions are held with a variety of national
drug-control stakeholders, including policymakers, repre-
sentatives of regulatory bodies, health-care experts, people
working in the fields of prevention, treatment, rehabilita-
tion and social reintegration, law enforcement and border
control officials, staff of forensic facilities and representatives
of civil society groups, including those representing people
with lived experience.
223. On the basis of the findings of each mission, the Board
adopts a series of recommendations aimed at strengthen-
ing national drug control by suggesting specific courses of
action to address challenges identified in each country. The
recommendations are communicated confidentially to the
Governments concerned for their consideration.
224. In the current report, information is provided
on the missions that the Board undertook to Cyprus,
Kyrgyzstan and the United States. Additional missions
have been accepted in principle by the Governments of the
Bahamas, Brunei Darussalam, Colombia, Cuba, Dominica,
El  Salvador, Eswatini, the Gambia, Greece, Honduras,
Mexico, the Niger, the Philippines, Tajikistan, Thailand,
Venezuela (Bolivarian Republic of) and Yemen, but plans for
those missions have not yet been finalized. In addition, the
Board has contacted the Governments of Bahrain, Belize,
Cameroon, Djibouti, Grenada, Guinea, Japan, Kazakhstan,
Kuwait, the Lao People’s Democratic Republic, Lesotho,
Liberia, Maldives, Mali, North Macedonia, Rwanda, Saint
Lucia, South Sudan and Suriname, expressing its wish to
carry out missions to those countries.
of Cyprus was established as an interministerial body that
coordinates with all relevant stakeholders in the develop-
ment and implementation of national strategies and action
plans on drug control.
227. The Board took note of various drug control initia-
tives of the Government and the progress made, including
the latest data on drug prevalence from its general popula-
tion survey of 2023.
(b) Kyrgyzstan
228. During its mission to Kyrgyzstan, which took place in
December 2022, the Board examined developments in the
country’s drug control policies, in particular in response to
the needs of people who use drugs and the national secu-
rity concerns arising from increased drug trafficking in the
region.
229. The INCB delegation discussed with the Government
and civil society representatives how, since the previous
mission of the Board, in 1997, the extensive political and
legislative changes in the country had affected the country’s
drug control landscape. Continual political and legislative
reforms appear to have resulted in challenges and impedi-
ments to effective and balanced drug control.
230. The Board noted that the country’s drug control
efforts would benefit from the allocation of additional
resources and also noted the need to improve coordina-
tion between the Government and civil society with a
view to developing an informed and balanced approach to
addressing the country’s drug use and trafficking problems.
Persistent socioeconomic challenges, such as a lack of access
to affordable health care, have affected public health initia-
tives and priority concerns such as ensuring the availability
of controlled medicines and limiting the spread of HIV, in
particular in prison settings.
(a)
Cyprus
(c)
United States of America
225. In September 2023, the Board undertook a mission to
Cyprus to discuss the drug control situation in the country
and the status of implementation of the three international
drug control conventions, to which Cyprus is a party.
226. Since the Board’s last mission to Cyprus in 1998, the
country has gone through considerable changes. Cyprus
joined the European Union in 2004 and started to apply
European Union drug policies, for both supply and demand
reduction and introduce drug policies based on health and
human rights approaches. The National Addiction Authority
231. An INCB mission to the United States took place in
December 2022. The objective of the mission was to review
the drug control situation in the country and to discuss with
the Government its compliance with the international drug
control treaties. In particular, the Board wished to obtain
information on the institutional framework on drug control;
the legislative and policy measures related to drug control
at the federal and state levels, including with respect to can-
nabis; regulatory control mechanisms and reporting to the
Board; supply reduction efforts; precursor chemicals con-
trol; and measures aimed at the prevention and treatment
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INCB REPORT 2023
of drug use and the rehabilitation and social integration of
people who use drugs.
232. The Board noted that, in the previous two decades,
the country had struggled with the public health effects of
an “opioid epidemic” – made worse by the overdose deaths
related to the consumption of synthetic opioids – which had
claimed an estimated 1 million lives and exacted a major
toll on public health and the country’s economy. The Board
stands ready to assist the Government in addressing this
matter through the tools it has at its disposal.
233. In response to this and other matters relating to the
implementation of the provisions of the international drug
control conventions, the Board noted that the Government
had developed legal and policy frameworks governing all
aspects of drug control, guided by the 2022 National Drug
Control Strategy. It has a robust supply-reduction apparatus,
is committed to international cooperation on drug control
matters and is a major provider of financial and technical
assistance at the international level.
234. Although cannabis remains subject to the highest
level of control under the Controlled Substances Act, use of
the drug has been legalized in several states for non-medical
purposes. The Board has repeatedly expressed its concern
that these developments may be inconsistent with the coun-
try’s legal obligations as a party to the three international
drug conventions.
235. The Board continues to maintain a constructive dia-
logue with the Government of the United States on these
matters.
following missions undertaken in 2019 or earlier, namely
Chile, Côte d’Ivoire, the Democratic People’s Republic
of Korea, Egypt, Madagascar, Mauritania, Montenegro,
Sri Lanka and Uzbekistan, as well as Kosovo,
118
to provide
their pending reports.
238. The Board wishes to express its appreciation to the
Governments of Chile, the Democratic People’s Republic of
Korea, Egypt, Jordan, Tunisia and Uzbekistan for submit-
ting the information on follow-up to the Board’s missions to
those countries and reiterates its call upon the Governments
of Côte d’Ivoire, Madagascar, Mauritania, Montenegro and
Sri Lanka, as well as the government of Kosovo,
118
to provide
the information requested at the earliest opportunity.
(a) Chile
239. In March 2019, the Board undertook a mission to
Chile, to discuss the Government’s implementation of the
three international drug control conventions, to examine
drug policy developments and to assess the drug-related
challenges being faced by the country. In April 2023, the
Government of Chile submitted a progress report relating
to the institutional framework introduced to address both
drug supply and demand reduction efforts and reporting
on practical efforts relating to border control and drug use
prevention.
240. The Board took note of the launch by the
Government of its first national policy on organized crime.
Implementation is being coordinated by the Ministry of the
Interior and Public Security; the policy brought together
17 government institutions to enhance inter-institutional
coordination in order to better address organized crime. A
key focus was improving areas such as container control,
information analysis, the transfer of information and the
updating of risk analysis systems. Concrete steps included
the signing of a memorandum of understanding with the
UNODC-WCO Global Container Control Programme to
implement activities at two ports in the country.
241. Concerning drug use prevention, the Government
reported that by the end of 2022, social reintegration ser-
vices had been established in five regions of the country,
with coverage to be expanded to three more regions in
2023. The overall objective was to contribute to the sus-
tainability of the achievements made in treating children,
adolescents, young people and adults; reducing the stigma
attached to individuals with problematic use of various types
of substances; and helping to create equal opportunities for
References to Kosovo shall be understood to be in the context of
Security Council resolution 1244 (1999).
118
3. Evaluation of the implementation by
Governments of recommendations
made by the Board following its
country missions
236. Every year, the Board follows up on developments in
countries that received INCB country missions three years
prior and requests the Governments of those countries to
provide information on legislative or policy actions taken to
implement the Board’s post-mission recommendations and
on any other drug-related developments that have occurred
in the country since the mission was carried out.
237. As no missions were carried out in 2020 because of
the COVID-19 pandemic, in 2023, the Board invited the
Governments of the countries and territories that had not
yet submitted their reports or had submitted incomplete
reports on the implementation of the recommendations
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children, adolescents, young people and adults facing social
exclusion on account of their substance use.
242. The Government also provided information on the
drug and alcohol treatment courts programme; those courts
were used to provide an alternative procedure for adult and
adolescent offenders with problematic use of psychoactive
substances. The aim of the courts was to facilitate the iden-
tification of those who engage in problem drug use and to
ensure that they receive treatment, helping them to lessen
their consumption of such substances, as well as reducing
the risk of recidivism. As at March 2022, the programme
was operating 35 courts in 11 regions of Chile.
243. Finally, during the mission in 2019, it was observed
that the Government was considering legislative provisions
authorizing the self-cultivation of cannabis for medical pur-
poses. While no update on this matter was provided in the
progress report, the Board reiterates that authorizing the
self-cultivation of cannabis for medical and scientific pur-
poses may contravene the international drug control trea-
ties, in particular the 1961Convention.
issues with the current legal framework that would result in
reduced availability of substances for medical and scientific
use, the Board urges the Government to continually review
the mechanisms in place to ensure their adequacy.
247. The Ministry of Public Health confirmed that it had
conducted an assessment of trade discrepancies in rela-
tion to psychotropic substances as raised by the mission
and reported that no inconsistencies in such trade were
noted during the global health crisis. The Board remains
concerned that discrepancies relating to international ship-
ments of both narcotic drugs and psychotropic substances
continued to be identified, and the Board stands ready to
assist the Government in addressing the matter to improve
the Government’s control and monitoring of international
trade.
(c) Egypt
248. In June 2017, the Board undertook a mission to Egypt
to review the Government’s compliance with the provisions
of the international drug control treaties and its cooperation
with the Board.
249. Following upon previous reports, the Government
of Egypt submitted additional information during the
reporting period describing efforts to strengthen the drug
control system in the country in line with the Board’s
recommendations.
250. The Board commends the Government of Egypt for
the extensive information that it has provided, including
data based on population surveys, such as the national com-
prehensive survey on narcotic drug demand, regarding the
use of new psychoactive substances.
251. While welcoming the progress made in the imple-
mentation of its recommendations, the Board reiterates its
encouragement to the Government of Egypt to actively use
the INCB tools, including I2ES, PICS and IONICS, devel-
oped for Governments to facilitate the trade of internation-
ally controlled substances and prevent trafficking in new
psychoactive substances and to continue to take measures
to promote the adequate availability of controlled narcotic
drugs and psychotropic substances for medical purposes.
(b)
Democratic People’s Republic of Korea
244. In September 2019, the Board undertook a mission
to the Democratic People’s Republic of Korea in order to
review the drug control situation in the country and the
implementation of the three United Nations drug control
treaties, including reporting to and cooperation with INCB,
in accordance with the conventions.
245. The Board received a progress report from the
Government of the Democratic People’s Republic of Korea
in June 2023, informing that the Drug Management Law of
the Democratic People’s Republic of Korea was amended on
14 December 2021. Supply reduction efforts were reported
to be further enhanced through the Law on Customs of the
Democratic People’s Republic of Korea, which prohibits the
import and export of illicit drugs and precursor chemicals
and, pursuant to that law, the Customs Bureau was working
in close cooperation with bordering countries to prevent the
trafficking of illicit drugs and precursors.
246. At the time of the mission, the reported consump-
tion of narcotic drugs for medical and scientific purposes
in the Democratic People’s Republic of Korea was one of the
lowest not only in Asia but in the world. The reported con-
sumption of psychotropic substances for licit purposes was
also very low, and the Board encouraged the Government
to examine the causes for the underutilization of narcotic
drugs and psychotropic substances for medical purposes.
While the Government assured the Board that there were no
(d) Jordan
252. In October 2019, the Board undertook a mission to
Jordan in order to discuss the Government’s implementa-
tion of the three international drug control conventions and
to examine drug policy developments in the country. The
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INCB REPORT 2023
Board received an initial response from the Government
of Jordan in January 2022 with more detailed information
on treatment and rehabilitation services being received in
July 2023.
253. The Government reported that, due to the successful
experiences of the Addiction Treatment Centre affiliated
with the Public Security Directorate of the Anti-Narcotics
Department, the Centre was expanded to 170 beds and is
now equipped with sports facilities, pottery and sewing
workshops and computer laboratories. The Government
reported that the Centre observed treatment protocols that
conform with the relevant international standards and that
treatment was provided to 951 people in 2022. Based on
these experiences, a further 40-bed facility was established
to treat people who use drugs in one of the country’s correc-
tional and rehabilitation centres. While treatment services
had been expanded in the northern and southern regions
of the country, solutions were however still being sought
for treating juveniles.
254. High levels of international cooperation were
reported by the Government in order to deal with cross-
border drug trafficking faced by the country. Ongoing
efforts include exchanging information with liaison officers
concerning drug smuggling networks, suspicious persons
and smuggling routes and modi operandi. An Electronic
Surveillance Office was also created to address drug traf-
ficking operations via the Internet, including on social net-
working sites.
255. The Board takes note of the steps introduced by the
Government of Jordan and understands that a draft national
strategy to combat narcotic drugs has been pending with the
office of the Prime Minister since 2020. The Government is
urged to finalize this strategy as a matter of urgency in order
complement the initiatives already introduced to address the
country’s drug use situation and data collection methods.
The survey revealed an increase in the use of drugs since
the second MedSPAD survey in 2017, highlighting the need
for the establishment of health-care facilities similar to the
AMAL Center and of a national drug observatory.
258. The Minister of Health approved a national strategy
in June 2021 for preventing and reducing the risks of, and
treating, disorders related to the use of illicit psychoactive
substances in community and prison settings, covering
the period 2023–2027. The strategy was drawn up by two
experts – national and international – within the framework
of cooperation with UNODC, and an order for the deliv-
ery of methadone to Tunisia had been placed by the Global
Fund as a part of the implementation of the national strat-
egy and in the context of treatment for people who inject
opioids.
259. The Board took note of the activities initiated by the
authorities of Tunisia to reform legislation, prepare and
implement a national action plan and introduce effective
precursor chemical control, but is concerned that many of
those reforms have not yet been finalized. The Government
is urged to address these issues as a matter of urgency.
(f ) Uzbekistan
260. In March 2019, the Board undertook a mission to
Uzbekistan to discuss the drug control situation in the
country and the status of implementation of the three inter-
national drug control conventions.
261. In April 2023, the Government of Uzbekistan submit-
ted a progress report on the implementation of the Board’s
recommendations following its mission to the country. The
Government of Uzbekistan reported that measures had been
taken to prevent the illegal distribution of pharmaceutical
preparations outside pharmacies and to strengthen control
over the quality of such preparations. The Board acknowl-
edges that efforts have been made to strengthen the proce-
dures for the import, export and transit of narcotic drugs,
psychotropic substances and precursors on the territory of
Uzbekistan and to control the movement thereof.
262. The Board takes note of challenges posed to
Uzbekistan by drug trafficking from Afghanistan and com-
mends the Government for its supply-reduction efforts, in
particular with regard to the work of law enforcement agen-
cies aimed at eliminating channels used for the transit and
sale of narcotic drugs and at coordinating and organizing
operational and preventive measures to reduce the demand
for narcotic drugs and psychotropic substances.
(e) Tunisia
256. In October 2018, the Board undertook a mission
to Tunisia with a view to comprehensively discussing with
the Government the various issues relating to national drug
control and the measures necessary to achieve the objectives
of the international drug control treaties at both the policy
and technical levels. Additional information relating to the
Board’s recommendations were received in July 2023.
257. The Government reported that the third survey
on the use of tobacco, alcohol and drugs in schools was
undertaken in 2021 as part of the Mediterranean School
Survey Project on Alcohol and Other Drugs (MedSPAD).
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Chapter II. FunCtIonIng oF the InternatIonal drug Control system
41
263. With regard to the non-medical and non-scientific
use of narcotic drugs and psychotropic substances, the
Board noted the information provided by the Government
of Uzbekistan regarding the joint preparation of a survey,
in cooperation with UNODC, to assess the prevalence of
drug use in the country.
264. In 2020, the Government of Uzbekistan approved
legislation to regulate matters relating to the treatment of
drug use, based on the principles of legality, confidentiality
and social protection, and to provide resources and equip-
ment for drug use treatment services. The Government also
approved a programme of measures for the further devel-
opment of the drug use treatment service for the period
2022–2026.
265. The Board welcomes the willingness of the
Government of Uzbekistan to register with and be trained to
use the IONICS platform and the PEN Online system. The
Board acknowledges the efforts made to set up preventive
programmes, with the involvement of community-based
institutions and civil society.
and parameters under which these confidential consulta-
tions are to be held.
267. Since its inception, INCB has invoked these
compliance-related provisions with respect to a number of
States in order to initiate formal consultations with them to
examine potential issues of non-compliance through active
dialogue, requests for additional information and requests
for remedial actions to be taken, as deemed appropriate.
268. Pursuant to the relevant provisions of the conven-
tions, the fact that consultations have been initiated and
the name of the State concerned are not publicly disclosed
by the Board unless it decides to bring the situation to the
attention of the parties, the Economic and Social Council
or the Commission on Narcotic Drugs in cases where the
State party in question has failed to give satisfactory expla-
nations when called upon to do so or has failed to adopt any
remedial measures that it has been called upon to take, or
where there is a serious situation that requires cooperative
action at the international level with a view to addressing
non-compliance.
D. Action taken by the Board to
ensure the implementation of
the international drug control
treaties
1.
Action taken by the Board pursuant
to articles 14 and 14 bis of the Single
Convention on Narcotic Drugs of 1961
as amended by the 1972 Protocol,
article 19 of the Convention on
Psychotropic Substances of 1971 and
article 22 of the Convention against
Illicit Traffic in Narcotic Drugs and
Psychotropic Substances of 1988
2.
Consultation with the Government
of Afghanistan pursuant to articles
14 and 14 bis of the 1961 Single
Convention on Narcotic Drugs as
amended by the 1972 Protocol
269. In May 2000, the Board decided to invoke arti-
cle 14 of the 1961 Convention as amended with respect
to Afghanistan, having determined that the country had
become the world’s largest illicit producer of opium, seri-
ously endangering the aims of the Convention. Pursuant to
paragraph 1 (a) of article 14, the Board decided to propose
to the then de facto authorities of Afghanistan the open-
ing of consultations in order to identify possible courses
of action to address the grave threats to international drug
control posed by the situation in the country.
270. Consultations with Afghanistan continued pursuant
to article 14 of the 1961 Convention as amended following
the transition to a civilian Government in 2001 until its
overthrow by the Taliban in August 2021.
271. In May 2018, the Board also invoked article 14 bis of
the 1961 Convention as amended in order to call upon the
competent organs and specialized agencies of the United
Nations system to provide technical and financial assistance
to the Government of Afghanistan in support of its efforts
to carry out its obligations under the 1961 Convention as
amended.
266. When the Board has objective reasons to believe
that the aims of the international drug control treaties are
being seriously endangered by the failure of a State party
to comply with the legal obligations contained therein, or
there is a serious situation requiring cooperative action at
the international level, the Board may decide to engage in
a formal dialogue with the State in question with a view to
fostering compliance with the treaties. This formal process
is set forth in articles 14 and 14 bis of the 1961 Convention
as amended, article 19 of the 1971 Convention and article
22 of the 1988 Convention, which establish the formal steps
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INCB REPORT 2023
272. With the question of the diplomatic representation
of Afghanistan at the United Nations still being considered
by the Credentials Committee, there was no communi-
cation between the Board and the de facto authorities of
Afghanistan during the period under review. However, the
Board continued to underscore the need to support the
Afghan population in its meetings with partners, includ-
ing UNODC, WHO, the Commission on Narcotic Drugs
and the Economic and Social Council.
in government contracts or employing relatives in institu-
tions under their responsibility, and regulating the distribu-
tion, lease and sale of government land.
122
278. Women and girls continued to be particularly affected
by the systematic curtailment of human rights. In late 2022,
the Taliban issued several decisions resulting in the exclu-
sion of women from university education until the “right
sharia environment in line with Afghan culture” has been
established. In January 2022, the de facto authorities issued
instructions for reopening educational facilities for girls’
classes up to the sixth grade in the provinces where they
had previously been suspended. At the same time, another
set of instructions were issued prohibiting private tertiary
institutions from registering female students for entrance
examinations until further notice, entailing the suspension
of university education for women.
279. In December 2022, the Taliban announced a ban
on women working for national and international non-
governmental organizations. Additional measures restricting
women’s rights have included the closure of women-owned
and operated businesses and the banning of women from
frequenting public parks.
280. On 5 April 2023, the de facto Ministry of Foreign
Affairs verbally informed the Special Representative of the
Secretary-General for Afghanistan and Head of UNAMA
that with immediate effect, no Afghan woman would be
permitted to work for the United Nations in Afghanistan,
with exemptions applicable only to the education and health
sectors. In response, the United Nations issued statements
of condemnation on 5 and 11 April, indicating that it would
request all United Nations national personnel, irrespective
of gender, not to report to United Nations offices, with lim-
ited exceptions made for critical tasks.
123
In its resolution
2681 (2023) of 27 April 2023, the Security Council con-
demned the decision by the Taliban to ban Afghan women
from working for the United Nations in Afghanistan.
281. Further limitations on women’s access to educa-
tion have been condemned by the Secretary-General,
UNAMA leadership, the Office of the United Nations
High Commissioner for Human Rights (OHCHR) and the
Office for the Coordination of Humanitarian Affairs. Public
protests in Afghanistan against the restriction of women’s
rights have been violently repressed, with protesters facing
warning shots, water cannons, threats, beatings, arrests and
detention.
Situation in Afghanistan
273. During the reporting period, Afghanistan continued
to face significant challenges, including severe humanitarian
needs, a substantially weakened economy and the further
curtailment of the human rights of the civilian population
by the de facto authorities.
274. Conflict-related security incidents continued to take
place in Afghanistan. Islamic State in Iraq and the Levant-
Khorasan (ISIL-K) claimed responsibility for several high-
profile attacks targeting civilians and the Taliban. Several
armed clashes with the de facto authorities took place
during the reporting period, which were mainly led by three
resistance groups, namely, the National Resistance Front, the
Afghanistan Freedom Front and the Afghanistan Liberation
Movement.
119
275. The de facto authorities of Afghanistan continued
to make senior appointments within the Government and
security and justice sectors at the central and provincial
levels. All appointees were male and predominantly Taliban
affiliates.
120
276. The de facto authorities also continued to overhaul
the justice system, in particular through the restructuring of
courts, the disqualification of lawyers, the repeal of existing
laws and the promulgation of edicts on the application of
punishments purported to be consistent with sharia law. In
November 2022, the de facto Ministry of Justice published
five decrees, including one outlining the procedure for
making laws, regulations and procedures. In January 2023,
the leader of the Taliban issued a decision that declared all
rules and regulations adopted by the former Government
contrary to sharia law and void.
121
277. Several anti-corruption decrees were issued by the
leader of the Taliban during the reporting period, including
decrees prohibiting the de facto officials from participating
119
120
121
A/77/914-S/2023/453.
A/77/772-S/2023/151 and A/77/914-S/2023/453.
Ibid.
122
123
A/77/914-S/2023/453.
Ibid.
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
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282. The Board notes with serious concern that
Afghanistan continues to face a major humanitarian crisis.
Rapid surveys by the Gender in Humanitarian Action
Working Group and the Humanitarian Access Working
Group found that 67 per cent of 129 responding organiza-
tions reported that female staff were not coming to the office
following the ban of 24 December 2022 on Afghan women
working in non-governmental organizations. As at March
2023, 77 per cent of women-led organizations had either
fully or partially ceased their activities and 54 per cent did
not have sufficient funding to continue activities.
283. The Secretary-General reported that projections
indicate limited prospects for growth and poverty reduc-
tion because of limited investment in development, and that
millions of Afghans are dependent on international humani-
tarian assistance flows. There is a critical shortage of humani-
tarian funding for 2023, with the Afghanistan Humanitarian
Response Plan 2023 having received only 9 per cent of the
total requirement of $4.63 billion as at 2 June 2023.
284. Humanitarian organizations continued to supply
food and livelihood support, health care, help to address
acute malnutrition, water, sanitation and hygiene assistance,
education, emergency shelter and household items to the
Afghan population in need. The assistance continued despite
the high incidence of interference in the implementation of
humanitarian activities, including attacks on humanitarian
personnel, assets and facilities and numerous gender-related
incidents against female staff.
285. On 8 March 2023, the de facto authorities issued a
decree banning cannabis cultivation in Afghanistan, stating
that “in case of a violation, the plants would be destroyed, and
violators would be punished according to sharia laws”.
124
On
the same day, the de facto Deputy Minister of the counter-
narcotics authority called upon countries in the region to
cooperate in addressing drug and precursor trafficking and
money-laundering and providing alternative livelihoods to
farmers who had been affected by the earlier ban on the
cultivation of narcotic drugs announced in April 2022.
286. It appears that the price of high-quality cannabis
resin in Afghanistan increased by 10 per cent after the latest
cannabis ban was issued. More information on drug-related
developments in the country is presented chapter III of the
present report.
United Nations action
287. On 16 December 2022, the General Assembly
approved the decision of the Credentials Committee to
“postpone its consideration of the credentials” for Myanmar,
Afghanistan and Libya “and to revert to consideration of
these credentials at a future time in the seventy-seventh ses-
sion”, which ended in September 2023.
125
288. In January 2023, in the face of limitations on women’s
rights, a four-day United Nations mission to Afghanistan
was conducted on behalf of the Secretary-General by
the Deputy Secretary-General, the Executive Director of
UN-Women and the Assistant Secretary-General of the
Department of Political and Peacebuilding Affairs and the
Department of Peace Operations in order to express the
Organization’s concerns about the exclusion of women
from education and public life and to request the Taliban
to reconsider these measures in light of the fundamental
role played by Afghan women in the country’s continued
development.
126
289. On 16 March 2023, the Security Council unanimously
adopted resolution 2678 (2023), extending the mandate of
UNAMA until 17 March 2024. In the resolution, the Security
Council stressed the critical importance of a continued pres-
ence of UNAMA and called upon all relevant Afghan politi-
cal actors and stakeholders, including relevant authorities
and international actors, to coordinate with UNAMA in
the implementation of its mandate and to ensure the safety,
security and freedom of movement of United Nations and
associated personnel throughout the country.
290. On the same day, the Security Council also adopted
resolution 2679 (2023), in which it requested the Secretary-
General to conduct and provide an integrated, independ-
ent assessment, after consultations with all relevant Afghan
political actors and stakeholders. The Council requested
that the independent assessment provide forward-looking
recommendations for an integrated and coherent approach
among relevant political, humanitarian and develop-
ment actors, within and outside of the United Nations
system, in order to address the current challenges faced by
Afghanistan, including those relating to the humanitarian
situation, human rights, especially the rights of women and
girls, religious and ethnic minorities, security and terrorism.
291. On 3 July 2023, the United Nations country team
launched the Strategic Framework for Afghanistan for the
125
126
A/77/600, para. 11.
Ariana News, “IEA’s supreme leader bans cultivation of cannabis
in Afghanistan”, 19 March 2023; and TRT World, “Taliban leader bans
cannabis cultivation in Afghanistan”, 19 March 2023.
124
UNAMA, “High-level UN delegation led by the Deputy Secretary-
General calls on Afghanistan’s de facto Taliban authorities to reverse
course on recent decrees limiting women’s and girls’ rights, says Afghans
must not be abandoned”, 22 January 2023.
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INCB REPORT 2023
period 2023–2025, implementation of which had been
paused because of the ban imposed by the de facto author-
ities on Afghan women working for non-governmental
organizations in December 2022. The Strategic Framework
is a planning instrument that articulates the approach of
the United Nations to addressing basic human needs in
Afghanistan, prioritizing the needs and rights of the most
vulnerable, including women and girls, children and young
people, internally displaced persons, returnees, refugees and
ethnic and religious minorities.
127
292. In May 2023, the Secretary-General convened a
meeting of special envoys on Afghanistan to strengthen
international engagement around common objectives. A
special coordinator of the independent assessment man-
dated by the Security Council in its resolution 2679 (2023)
attended the meeting as an observer. Participants high-
lighted the need for a strategy of engagement that allows
for the stabilization of Afghanistan but also for addressing
important concerns shared by the international community,
which include the lack of inclusive governance, violations
of human rights, the presence of terrorist organizations and
the spread of drug trafficking.
128
293. UNAMA continued to facilitate outreach meetings
on governance-related issues, including principles of good
governance, service delivery and girls’ access to educa-
tion, between local de facto authorities, ulama, civil society
organizations, the media, young people and other com-
munity members in 16 provinces. In addition, UNAMA
continued to promote regional cooperation by hosting
monthly meetings of Kabul-based regional ambassadors in
order to coordinate engagement with the de facto authori-
ties. UNAMA noted with concern that the enforcement of
the severe restrictions on Afghan female personnel of the
United Nations was affecting United Nations outreach to
Afghan stakeholders, particularly women.
129
294. UNODC continued to provide an alternative devel-
opment programme, which had reached more than 2,375
households, 47 per cent of which were female-headed, in
Helmand, Kandahar, Laghman and Nangarhar Provinces.
The programme, which is funded by the Governments
of Italy and Japan, together with contributions from the
United Nations Strategic Framework for Afghanistan, sup-
ports farmers with improved vegetable production, poultry
farming, cereal crop production, animal husbandry and
dairy processing and by connecting beneficiaries to the
local markets. UNODC also provided essential medicine,
UNAMA, “UN launches new Strategic Framework for supporting
Afghan people”, 3 July 2023.
127
medical equipment, supplementary food packages and basic
hygiene kits to 24 drug treatment centres and seven drop-in
centres.
130
3.
Supporting Governments’
compliance with the treaties
(a) INCB Learning
295. INCB Learning is the Board’s initiative to enhance the
ability of Governments to estimate and assess their require-
ments for internationally controlled substances for medi-
cal and scientific purposes, in compliance with the three
international drug control conventions. Since its launch in
2016, the programme has been supporting Member States
and their competent national authorities in implementing
the recommendations contained in the outcome document
of the special session of the General Assembly on the world
drug problem, held in 2016, and the reports of the Board
for 2015, 2018 and 2022 on the availability of internationally
controlled substances.
131
296. The objective of INCB Learning is to promote the
adequate availability of narcotic drugs and psychotropic
substances required for medical and scientific purposes,
while preventing their abuse and diversion into illicit chan-
nels. The submission to the Board of timely and accurate
national reports of estimated requirements and statistical
data for controlled substances and estimates of annual legiti-
mate requirements for precursors is essential to achieving
this objective.
297. INCB Learning supports Member States in fully
implementing and complying with the international drug
control conventions through training and awareness-raising.
Capacity-building activities include regional training semi-
nars, availability workshops, e-modules, bilateral consulta-
tions and, since mid-2020, in response to the COVID-19
pandemic, online training sessions.
298. An INCB Learning subregional in-person training
seminar and an awareness-raising availability workshop for
officials from the competent national authorities of Costa
Rica, the Dominican Republic, El Salvador, Guatemala,
Honduras and Panama were held in San Salvador from
13 to 17 February 2023. Over four days, 34 officials par-
ticipated in 18 training sessions, which were dedicated to
expanding knowledge of the provisions of the international
130
131
UNAMA, “Secretary-General’s statement following two-day
meeting of special envoys on Afghanistan”, 3 May 2023.
128
129
Ibid.
A/77/914-S/2023/453.
E/INCB/2015/1/Supp.1, E/INCB/2018/1/Supp.1 and
E/INCB/2022/1/Supp.1.
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drug control treaties and further strengthening capacity for
improved treaty implementation. A one-day awareness-
raising availability workshop brought together special-
ists from Governments, WHO/the Pan American Health
Organization (PAHO) and civil society to find ways to
improve access to narcotic drugs and psychotropic sub-
stances for medical use in the subregion. Both activities were
organized in close collaboration with the Government of
El Salvador and CICAD.
299. On 8 and 9 June 2023, INCB Learning held a two-day
virtual workshop focused on raising awareness of the avail-
ability of controlled substances for medical and scientific
purposes as part of the Board’s ongoing efforts to support
Member States in ensuring that essential medicines are
available, while preventing their diversion and abuse. The
event brought together officials from the competent national
authorities of Armenia, Azerbaijan, Belarus, Kyrgyzstan,
the Russian Federation, Tajikistan and Uzbekistan and a
diverse group of stakeholders that included representatives
from palliative care associations, experts in drug control
and public health, and members of the international com-
munity. Over the two days, participants discussed various
themes related to improving access to controlled substances
for medical purposes, including regulatory frameworks, bar-
riers to access, and the importance of national and inter-
national cooperation.
300. Both in-person and virtual INCB Learning seminars
are evaluated anonymously by participants. In past years, the
activities have received high ratings and evaluations have
consistently shown that the content meets participants’
expectations, the sessions are highly relevant and the learn-
ing materials are of a high quality.
301. E-modules are a valuable tool for closing knowledge
gaps. To date, INCB Learning has developed five e-modules
to support Governments in their implementation of the
international drug control treaties. Available in English,
French, Russian and Spanish, as well as Portuguese, the
five e-modules offer interactive, self-paced training. The
e-modules cover the following thematic areas:
(a)
the
system of estimates of annual legitimate medical and sci-
entific requirements for narcotic drugs;
(b)
the system of
assessments of annual legitimate medical and scientific
requirements for psychotropic substances;
(c)
the system
of estimates of annual legitimate requirements for imports
of precursors of amphetamine-type stimulants;
(d)
the inter-
national drug control framework and the role of INCB; and
(e)
ensuring adequate availability of internationally con-
trolled substances for medical and scientific purposes.
302. Officials from competent national authorities con-
tinue to utilize the e-modules, and as at 1 November 2023,
1,462 officials, 67 per cent of whom were women, from
154  countries and territories had enrolled in INCB
Learning e-modules. Successful completion of the modules
is acknowledged with an online certificate; to date, 1,664
digital certificates have been issued. Those who have taken
the modules come from all regions of the world and their
countries are home to 95 per cent of the world’s population.
The Board encourages Governments to continue to reg-
ister officials of their competent national authorities for
the e-modules and to provide feedback on the content of
existing e-modules and suggestions for areas in which the
development of further training is needed.
303. In its capacity-building activities, INCB Learning
works with key partner organizations such as the African
Union Commission, CICAD, UNODC and WHO.
304. A compendium of frequently asked questions,
which was first developed in 2021, is available on the INCB
Learning website in English, French, Russian and Spanish. It
provides information on compliance with the provisions of
the three international drug control conventions and on the
regulatory control and monitoring of licit trade in narcotic
drugs, psychotropic substances and precursor chemicals.
Drug control officials can use the tool to find information
related to, for example, the accurate submission of forms
and timelines. Access to all the forms is also provided in
the compendium.
305. To assist competent national authorities in their
duties, all training materials have been consolidated and
are now available on a dedicated page of the INCB Learning
website. The page provides links to the text of the inter-
national drug control treaties in all six official languages and
Portuguese, training materials, guidelines, tools and forms
that support reporting to INCB.
306. INCB Learning newsletters are published regularly
on the INCB Learning website and disseminated to com-
petent national authorities upon subscription. The Board
invites national drug control officials interested in INCB
Learning activities and learning tools to subscribe to the
newsletter by sending an email to [email protected].
307.
The Board is grateful for the contributions to
INCB Learning made by the Governments of Australia,
Belgium, France, the Russian Federation, Thailand and
the United States and for the support offered by CICAD,
and encourages Governments to consider actively sup-
porting INCB Learning by participating in its activities
and providing the resources required to ensure the pro-
gramme’s continuation and expansion.
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INCB REPORT 2023
(b) International Import and Export
Authorization System
308. I2ES is an Internet-based electronic system devel-
oped by UNODC, with financial and technical support
from Member States, and administered by the Board to
allow for rapid paperless trade in internationally con-
trolled substances. Launched in 2015 pursuant to numerous
Commission on Narcotic Drugs resolutions, in particular
resolutions 55/6 and 56/7, I2ES allows for the secure issu-
ance and exchange of import and export authorizations
between countries, reducing the processing time for authori-
zations and the risk of diversions from forged authoriza-
tions. The system is compliant with the 1961 Convention
as amended and the 1971 Convention, and its importance
was recognized in the outcome document of the special ses-
sion of the General Assembly on the world drug problem,
held in 2016.
309. The INCB secretariat continually works to assist
Governments in registering and implementing I2ES within
their national drug control systems. Technical materials
regarding the platform and its functions are available on the
INCB website. The INCB secretariat also conducts webinars
for interested Governments to demonstrate the functional-
ity of the system.
310. I2ES is the only system approved by the Commission
on Narcotic Drugs for the issuance and exchange of import
and export authorizations pursuant to the provisions of the
1961 Convention as amended and the 1971 Convention.
Recent developments regarding the use of electronic import
and export authorizations among countries, including the
views of the Board on those developments, are discussed in
chapter III, section A, of the present report.
311. In the 12-month period ending on 1 November
2023, two Governments registered to use I2ES, bringing the
total to 77 Governments that have an active administrator
account. The number of Governments actively using I2ES is
slowly growing, and the frequency with which Governments
use the platform is increasing. During the 12-month period
ending on 1 November 2023, authorities from 14 countries
uploaded a total of 5,407 import authorizations and 1,202
export authorizations.
312. The Board has noted that some competent national
authorities wishing to use I2ES face legislative and regula-
tory hurdles at the national level. These include limitations
regarding how import and export authorization documents
are approved and the means by which such documents can
be transmitted or exchanged. Some countries require import
and export authorizations for internationally controlled sub-
stances to be issued as physical documents.
313. The Board has also noted that a certain lack of fea-
tures and technical limitations in I2ES make implementing
the system difficult for some Governments. This includes
the lack of a multilingual interface, support for nationally
controlled substances and advanced statistical reporting
functions. In addition, deeper integration between I2ES,
other INCB systems and some national-level systems would
allow for easier, quicker and more accurate data exchange
between Governments and the Board.
314. Updates to I2ES and PEN Online will be provided
in the context of the development of the next-generation
international drug control system, the INCB initiative to
update and expand the functionalities of the existing data-
base, the International Drug Control System (IDS). IDS
contains data that are provided by Governments pursuant
to the provisions of the international drug control treaties
and other international obligations enshrined in resolutions
of the Economic and Social Council and the Commission
on Narcotic Drugs, as well as information that is provided
voluntarily.
(c) Global Rapid Interdiction of Dangerous
Substances Programme
315. The INCB GRIDS Programme focal point net-
works form the robust infrastructure that enables the rapid
exchange of information and alerts and the development
of intelligence and facilitates operational action to assist in
investigations and in the dismantling of organized criminal
groups trafficking in non-scheduled dangerous substances.
As at 1 September 2023, there were 3,055 Project Ion focal
points representing 633 agencies from 193 Governments
and 21 international organizations, and 3,029 OPIOIDS
project focal points representing 621 agencies from 188
Governments and 21 international organizations.
316. As a result of the expanding focal point network,
the number of real-time incidents communicated through
IONICS has consistently grown and, in 2023, exceeded
77,000. Consequently, Governments have been able to
carry out investigations and analyses that have in turn led
to seizures of dangerous substances, arrests of traffickers,
prosecutions and disruptions of international trafficking
networks.
317. Leveraging the Project Ion, OPIOIDS project and
Project Prism (in relation to chemical precursors) law and
regulatory enforcement focal point networks, INCB coor-
dinated an operation (known as “Operation Knockout”)
to identify emerging global trafficking sources and desti-
nations of shipments of 1,4-butanediol, flubromazepam,
gamma-butyrolactone
and ketamine, substances associated
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
47
with drug-facilitated sexual assault reported in a number
of countries. The operation involved 160 law and regula-
tory enforcement officials from 76 national agencies and
organizations and six international partners. This led to
671 seizures, amounting to more than 785 kg and 225 litres
of drugs seized during the operational period. Of the total
incidents communicated, 282 incidents involved carisopro-
dol (141 kg and 100 units); 224 incidents involved ketamine
(516 kg and 7.2 litres); 101 incidents involved 1,4-butanediol
(46 kg and 200 litres); 61 incidents involved
gamma-butyro-
lactone (82 kg and 18 litres); and three incidents involved
flubromazepam (51 grams and 10 units).
318. One of the pillars of the GRIDS Programme is its
unique approach to public-private partnerships, assisting
Governments in their efforts to foster voluntary cooperation
with companies to prevent the exploitation of legitimate
services by traffickers. In this work, the focus is on four key
areas: manufacture, marketing, movement and monetiza-
tion. In the 12-month period ending on 1 September 2023,
expert group meetings and other related events were held,
bringing together leading global private sector partners
from a number of relevant sectors, including e-commerce
platforms, social media companies, chemical and drug man-
ufacturers and private postal and express mail and courier
services. These events resulted in operational outcomes,
as a substantial number of vendors of dangerous synthetic
opioids were identified by INCB and, through law and regu-
latory enforcement focal points, removed from e-commerce
platforms, thereby reducing the availability of fentanyls and
related dangerous substances.
319. Between 1 November 2022 and 1 November 2023,
five global alerts and special notices were circulated to
Project Ion and OPIOIDS focal points for voluntary
action by law, regulatory and private sector counterparts.
This included an alert relating to emerging trafficking in
tianeptine – a substance with opioid-like effects – and
trafficking in bromazolam and flunitrazolam, both emerg-
ing novel triazolobenzodiazepines with no known legitimate
use. The Board invites all relevant government authorities to
communicate seizures and suspicious shipments involving
these substances through IONICS.
320. Through the GRIDS Programme, in-person train-
ing courses were conducted, supplemented by distance-
learning technologies. Between 1 November 2022 and
31 October 2023, 26 training events were held on topics
that included raising awareness of new psychoactive sub-
stances and emerging opioids, information exchange using
IONICS, intelligence development and targeting using the
GRIDS Intelligence tool, safe handling of opioids and fen-
tanyls, personal protective equipment, presumptive test-
ing for synthetic opioids and interdiction methods. A total
of 533 law and regulatory enforcement officers and postal
inspection officers, representing 58 Governments and
two international organizations, took part in the training
courses and also received access to the eLearning Individual
Training Environment (ELITE) platform, which is offered in
the six official languages of the United Nations. The Board
recognizes the ongoing cooperation with its international
partners, in particular UPU, whose 2018 cooperation agree-
ment with INCB has significantly raised the awareness of
postal operators worldwide about the safe handling of pack-
ages containing dangerous substances.
321. Also through the GRIDS Programme, the sixth
annual operational meeting on countering trafficking in
dangerous synthetic drugs and chemicals through postal,
courier and air cargo services was held Vienna from 11 to
15 September 2023. The event brought together over 94 offic-
ers from 36 Governments, as well as several international
organizations and private sector entities. Participants iden-
tified the latest modi operandi for trafficking in synthetic
opioids and new psychoactive substances, exchanged case
studies and engaged in multilateral meetings to enhance
cooperation across borders.
322. In addition, under the GRIDS Programme, the third
international expert group meeting on expanding INCB lists
of dangerous substances with no known legitimate use and
novel approaches for their identification in falsified, sub-
standard or otherwise illicitly manufactured pharmaceuti-
cals was held in Vienna from 18 to 22 September 2023. The
event was attended by more than 40 representatives from 16
Governments, as well as several international organizations
and private sector entities.
323.
The Board encourages Governments and inter-
national organizations to enable their law and regulatory
enforcement focal points to take advantage of the suite
of INCB proprietary counter-trafficking tools, includ-
ing the Project Ion Incident Communication System
(IONICS) for secure real-time exchange of information
on incidents involving new psychoactive substances;
the GRIDS Intelligence HD strategic and operational
targeting platforms; the eLearning Individualized
Training Environment (ELITE) platform referred to in
Commission on Narcotic Drugs resolution 66/2; and
the Scanning of Novel Opioids on Online Platforms
(SNOOP) tool for the detection and dismantling of online
vendor marketplaces, along with the GRIDS Programme
operational activities.
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INCB REPORT 2023
(d) Project Prism and Project Cohesion
324. Since 2003 and 2006, respectively, Project Prism (in
relation to amphetamine-type stimulants and other syn-
thetic drugs) and Project Cohesion (in relation to illicit
manufacture of cocaine and heroin) have guided INCB
operational initiatives on precursors. Supported and often
engineered by the Precursors Task Force,
132
these operational
initiatives have resulted in valuable analysis and helped to
identify and address new trends in precursor trafficking, as
well as gaps and weaknesses in the international precursor
control system.
325. In October 2023, Operation Backup was launched
under Project Prism with the aim of generating information
on non-scheduled precursors of amphetamine-type stimu-
lants (P-2-P methyl glycidic acid and its esters, and esters
of 3,4-MDP-2-P methyl glycidic acid) and of fentanyl and
its analogues (4-piperidone and 1-Boc-4-piperidone). The
information gathered through Operation Backup will also
support the review of the chemicals targeted by INCB for a
possible scheduling recommendation to the Commission
on Narcotic Drugs in March 2024.
326. A closed, information-sharing meeting, organized
under Project Prism, was held in Vienna in June 2023. The
meeting facilitated the exchange of information among
countries in Africa, Europe and West Asia on the diversion
of and trafficking in pharmaceutical preparations containing
pseudoephedrine originating in Africa.
327. During the reporting period, INCB issued three
alerts through Project Prism. The first alert focused on a
new method of concealment for the smuggling of pseudo-
ephedrine; the second alert highlighted common character-
istics of a series of shipments of glycidic acid derivatives of
P-2-P and 3,4-MDP-2-P in the Netherlands; and the third
alert raised awareness of the identification of a new designer
precursor of MDMA and related “ecstasy”-type substances,
the sodium salt of isopropylidene (2-(3,4-methylenedioxy-
phenyl)acetyl)malonate (IMDPAM).
328.
The Board commends all Governments that have
supported the operational initiatives under Projects
Cohesion and Prism, including the time-bound intelligence-
gathering operations and case meetings. Further, in order
to ensure that follow-up investigations of precursor cases
The current members of the INCB Precursors Task Force are
Australia, China, Colombia, Germany, India, Mexico, Netherlands (King-
dom of the), Nigeria, the Russian Federation, South Africa, Switzerland,
Türkiye, and the United States, the International Criminal Police Organi-
zation (INTERPOL), UNODC, the World Customs Organization, the
European Commission and the Inter-American Drug Control Commis-
sion.
132
and suspicious shipments are conducted efficiently,
the  Board encourages all Governments to nominate
suitable precursors focal points, if they have not done
so, and to inform INCB of any changes or updates in a
timely manner.
(e)
Precursors Incident Communication
System
329. PICS is an online platform for the sharing by compe-
tent authorities of real-time actionable information related to
incidents and suspicious shipments involving precursors and
equipment used in illicit drug manufacture. PICS automati-
cally alerts users via email about new incidents. It allows users
to conduct both free text and structured searches with several
fixed and dynamic search options, enabling users to generate
tailor-made reports for intelligence and analysis. It also ena-
bles the sharing of pictures and documents that can be used
by countries in the conduct of backtracking investigations.
330. As at 1 November 2023, PICS had more than 600
registered users from 129 countries and territories and 300
organizations. Information related to over 4,300 incidents
that had taken place in more than 80 countries and that
involved nearly 300 substances had been shared through
PICS. A total of 77 incidents included information related to
equipment. In the reporting period, information on nearly
500 unique incidents involving nearly 1,200 communica-
tions on the substances involved (145 communications on
substances in Table I, 218 on substances in Table II, 553
on substances included in the limited international special
surveillance list of non-scheduled substances, 253 on non-
scheduled substances not included in that list and 47 on
cutting agents) was shared through PICS. Information on
14 cases involving laboratory equipment was also shared
through PICS during the same period.
331.
The Board encourages Governments to make
greater use of PICS and to share timely information on
incidents relating to precursors and laboratory equip-
ment with the requisite actionable details to enable the
conduct of investigations by law enforcement authorities
in the countries concerned.
The sharing of information
through PICS enables the Board to issue alerts through
Project Prism and Project Cohesion (see para. 327 above)
and to update the limited international special surveil-
lance list of non-scheduled substances. It also provides the
basis for conducting time-bound intelligence-gathering
operations.
332. Further details on the Board’s precursor-related oper-
ational activities can be found in the report of the Board
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ChAPTER II. fuNCTIONING Of ThE INTERNATIONAL DRuG CONTROL SySTEm
49
for 2023 on the implementation of article 12 of the 1988
Convention.
(g)
INCB newsletter on precursors
(f ) Pre-Export Notification Online Light
system
333. PEN Online Light is an online platform that is simi-
lar to PEN Online and that was launched in October 2022
for the voluntary exchange of information about legitimate
planned exports involving chemicals that are not controlled
internationally but that may be under national control in
some countries. As at 1 November 2023, 12 exporting coun-
tries had used PEN Online Light to inform 50 importing
countries and territories about 725 planned shipments of
chemicals not under international control.
The Board com-
mends those Governments that actively use PEN Online
Light and encourages the authorities of all other export-
ing countries and territories to consider using it with a
view to enhancing knowledge of international movements
of substitute and alternative chemicals that may be used
in the illicit manufacture of drugs.
334. To keep stakeholders abreast of developments and
initiatives in the areas of precursor control and equipment
that may be used in illicit drug manufacture, INCB publishes
a newsletter on a quarterly basis, which is disseminated to all
Project Prism and Project Cohesion focal points, competent
national authorities and relevant partners. Available data
indicate that the newsletter enjoys a high level of readership,
giving an indication of the interest of the targeted audience
for this service.
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Chapter III.
Analysis of the world situation
A. Global issues
1.
Precursor control in countries of
conflict
335. The diversion of precursors from licit trade can
happen at any stage along the distribution chain. While no
country is immune from attempts by traffickers to obtain
chemicals for illicit purposes, territories whose status is
unclear or contested or, at any given time, is not effectively
within the scope of control of an internationally recognized
entity’s competent national authorities are at increased risk
of being targeted by traffickers. The scenarios that give rise
to vulnerabilities vary in nature and include political insta-
bility, conflict and unresolved territorial disputes in vari-
ous forms, and civil war or prolonged civil unrest, and the
scenario in a given country may change over time. Places
in which such scenarios exist are referred to as countries of
conflict or conflict areas.
336. INCB has, on several occasions, expressed its concern
about the implications such scenarios have for international
precursor control and the risk of the territories concerned
being targeted by traffickers for the diversion of precursor
chemicals and/or activities associated with, or carried out in
preparation for, such diversion. In addition to the outright
diversion of precursors from companies located in conflict
areas, past incidents involving conflict areas have included
the placing of orders for precursors using the names of such
companies as a front, the channelling of diverted shipments
of precursors through the territory of countries of conflict,
and the forging of import authorizations.
337. International trade in precursors outside the PEN
Online system, which has become the central global system
for the exchange of pre-export notifications pursuant to arti-
cle 12, paragraph 10 (a), of the 1988 Convention, also brings
about a higher risk of diversion. This applies to importing
countries not using the system actively to monitor incom-
ing notifications. It also applies to exporting countries not
using the system, or not using it systematically, to notify
importing countries of every planned shipment prior to dis-
patch. Of particular concern is the trade in pharmaceutical
preparations containing scheduled precursors, especially
ephedrine and pseudoephedrine, which the Board and the
Commission on Narcotic Drugs have recommended be
monitored in the same manner as is the trade in the pre-
cursors that those preparations contain.
338. With regard to the trade in precursors destined for
countries of conflict, INCB is aware of a number of practical
challenges experienced by exporting countries. In particu-
lar, owing to the lack of integrity of controls in a disputed
territory, the authorities of exporting countries are often
unable to send pre-export notifications to and interact with
an officially recognized counterpart who has both the legal
authority and the capacity to provide adequate oversight
and assurance regarding a shipment’s end purpose or des-
tination. There may also be a lack of compliance with the
pre-export notification mechanism, namely, the practical
requirement for the authorities of importing countries to
view incoming notifications, a limited ability to verify the
legitimacy of a shipment and/or insufficient clarification
of the reasons for objecting to a shipment. All these fac-
tors leave the exporting country in a difficult position when
deciding whether or not a proposed export can proceed.
51
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INCB REPORT 2023
339. INCB has observed that, as a result of economic con-
siderations, shipments are being allowed to proceed more
often than not, even when only the minimum requirements
of article 12 of the 1988 Convention are being fulfilled. In
a few notable cases in the past, the authorities of exporting
countries have requested the exporting company to ensure
the secure transportation and handling of the substances in
the destination country up to their receipt by the import-
ing company.
INCB commends all efforts that contribute
to ensuring the availability of controlled precursors for
legitimate purposes in all regions of the world, irrespec-
tive of a country’s situation or a territory’s status, while
managing the risk of diversion. INCB further invites all
Governments to work with the Board to devise appropri-
ate ways and means of monitoring trade pursuant to arti-
cle 12 of the 1988 Convention and handling pre-export
notifications with a view to enabling the trade in chemi-
cals to and from high-risk areas in a regulated manner.
342. To facilitate international trade in ketamine while
ensuring compliance with national legislation, INCB sent a
questionnaire on the national control status of the substance
to all Governments in August 2008. Information on the
import and export authorization requirements for ketamine
from 123 countries and territories was then published and dis-
seminated through the INCB Secure Portal for Governments
(www.incb.org/incb/en/secured/governments.html).
343. In view of recent developments in the medical use
of ketamine and increasing non-medical use and seizures
reported by some Governments in recent years, the Board
decided to request updated information on the national
control status of the substance. Consequently, a question-
naire was sent to all Governments in April 2023. Replies
from 88 countries and 6 territories had been received as at
1 November 2023.
2.
Ketamine: an update on recent
developments and status of
national controls
Updates on national control status and
licit  use
344. Responses giving information on legislative updates
on the control status of ketamine were provided to INCB
by 101 Governments in 2023, in comparison with the 128
that provided such information in response to the INCB
questionnaire of 2008–2010.
345. Among those responding to the questionnaire sent
by INCB in 2023, around 70 per cent reported that they
had placed ketamine under national control. The level of
control to which the substance is subject, however, varies
from relatively strict control regimes under narcotics laws
to weaker reporting or licensing requirements under medi-
cines acts. Regardless of the control status, most respondents
(70 countries and 3 territories) require import and export
authorizations for international trade in the substance. A list
of the countries and territories that require such authoriza-
tions for ketamine is updated regularly and is available to all
Governments on the INCB Secure Portal for Governments.
The Board encourages importing Governments to issue
a letter of no objection or other proof of the legitimacy
of the import in cases where ketamine is imported from
countries where it is controlled.
346. Although only seven countries reported the licit
manufacture of ketamine, almost all respondents import the
substance for medical and scientific use, with some noting
increases in trade volume in recent years. In addition to
using ketamine as an anaesthetic for surgical and diagnostic
procedures, several countries have also approved its medical
use in controlled programmes as a treatment for patients
with treatment-resistant depression. Some respondents
340. Ketamine belongs chemically to the phenyl cyclohex-
amine class of drugs, and like other drugs in this class,
functions as a dissociative anaesthetic. First synthesized in
1962 and patented in Belgium in 1963, the substance has
been used as a general anaesthetic in human and veteri-
nary medicine. At sub-anaesthetic doses, ketamine is also
used in selected conditions for the management of pain and
depression. Given its affordable price and flexible modes
of administration, its use as an anaesthetic is particularly
important for developing countries and in emergency medi-
cine. Ketamine, which is included in the WHO Model List of
Essential Medicines and the WHO Model List of Essential
Medicines for Children, is not under international control.
341. Discussions on the control status of ketamine at
the international level started in the early 2000s, with the
substance first being pre-reviewed by the WHO Expert
Committee on Drug Dependence in 2002, then critically
reviewed by the Committee in 2006, 2012, 2014 and 2015.
While WHO recommended that ketamine not be placed
under international control, the Commission on Narcotic
Drugs, in its resolutions 49/6 of 2006 and 50/3 of 2007,
expressed concern over the widespread abuse of and
trafficking in ketamine and encouraged Governments to
consider placing it on the list of substances controlled under
national legislation and adopting a system of precautionary
measures for the timely detection of its diversion.
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
53
also reported ongoing projects and clinical trials to further
explore the therapeutic potential of ketamine in practice.
347. Alongside its expanding medical use, more than 20
countries reported greater use of ketamine for recreational
purposes and increasing seizures of the substance in recent
years. Often consumed in small quantities together with
other drugs at dance events, some Governments detected
greater recreational use of ketamine at more party venues,
and the emerging practice of ketamine injections and its use
in chemsex
133
since the end of the COVID-19 pandemic as
a public health emergency. Increases in both the number
of seizures and the volume of ketamine seized were also
reported. One country reported the emergence of ketamine
analogues in response to the placing of ketamine under
national control.
Given the resurgence of ketamine trafficking and non-
medical use, the substance has also been one of the target
substances in two INCB time-bound intelligence operations,
Operation Trance and Operation Knockout, which were
conducted in 2020 and 2023, respectively. In these opera-
tions, 50 and 224 ketamine incidents were reported, respec-
tively, with over 517 kg seized in the most recent operation.
In both operations, Western Europe and Central Europe
were the main source regions of seized consignments of
ketamine, accounting for some 80 per cent of the incidents
reported. In 2023, more countries were identified in rela-
tion to ketamine trafficking compared with three years
previously, with each continent having been identified at
least once as either a place of origin, destination or transit.
As at 1 November 2023, Governments had communicated
1,400 incidents involving a total of 5 tons of seized ketamine
through IONICS.
351. Previously, seized ketamine had typically been
diverted from licit markets. While diversion, and sometimes
theft, from legitimate channels continue to be significant
sources of supply for illicit uses, increasingly sophisticated
illicit laboratories have enabled illicit operators to synthe-
size ketamine from various internationally non-scheduled
chemical intermediates, a trend that started in Asia some
10 years ago. Since then, illicit ketamine laboratories have
been dismantled in Belgium, Cambodia, Canada, China,
including Hong Kong and Taiwan Province of China, India,
Malaysia and the Netherlands (Kingdom of the). Some of
the laboratories, in particular those in East and South-East
Asia, were industrial in scale, and sometimes used legiti-
mate front companies to import the necessary chemicals
and equipment.
352. Despite an increase in reports of illicit ketamine
manufacture, in their responses to the Board’s survey of
2023, only five countries reported that they were aware of
seizures of ketamine in which the substance was suspected
to have been illicitly manufactured; four of them reported
illicit manufacture on their territories.
353. Similarly, information about ketamine precursors
is scarce and not systematically reported, given that these
chemicals are not under international control. Nevertheless,
some countries submit such information to INCB. Reported
seizures of ketamine precursors have predominantly
involved two chemicals. Both substances are intermedi-
ates in the synthesis of ketamine and can readily be con-
verted into the substance. The substances can be considered
designer precursors, that is, they are made specifically to
circumvent existing legislation. Seizures of the two sub-
stances peaked in 2014, around the time that China pro-
posed that ketamine be placed under control in Schedule I of
the 1971 Convention. China has also been the country that
Illicit manufacture of and trafficking in
ketamine
348. More than 30 per cent of respondents to the INCB
survey carried out in 2023 reported ketamine seizures
or trafficking in ketamine involving their territory. This
included both trafficking in pharmaceutical preparations
and illicitly manufactured ketamine. Individual seizures typ-
ically involved small amounts, in the range of a few grams,
although occasional bulk seizures of a few kilograms, and
one seizure of 500 kg, were reported. The largest quanti-
ties were reported by countries in Asia, namely, Malaysia,
(2.6 tons seized in 2022), Myanmar (2.3 tons seized in
2022) and Thailand (nearly 1.8 tons seized in 2022), as well
as China, with seizures amounting to almost 1.8 tons since
2021, with the alleged countries of origin being Cambodia,
Thailand and Myanmar. India has also been identified as
the country of origin of a bulk seizure in Europe. Shipments
were often seized at land border crossings or among inter-
national postal packages at airports.
349. In South America, diverted ketamine is trafficked
for refinement into mixtures known regionally as “tuci” (or
“tucibi”, “fake 2C-B” or “cocaína
rosada”),
which consist of
varying combinations of ketamine, MDMA, amphetamine
and/or various new psychoactive substances. Similar prod-
ucts are known in South-East Asia as “happy water” and
“k-powdered milk”. Cases of “tuci” and “pink cocaine” have
also been reported in Europe and North America.
350. Globally, ketamine seizures peaked in 2015, and have
been increasing again since around 2018, both in terms of
frequency of trafficking incidents and the amounts seized.
The term “chemsex” refers to intentional sex under the influence
of psychoactive drugs, mostly among men who have sex with men.
133
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INCB REPORT 2023
most systematically reports the largest seizures of ketamine
precursors.
The Board commends the Governments that
voluntarily report seizures of ketamine precursors, their
sources and related contextual information. Similarly,
the Board commends Governments that use forensic
profiling analysis to determine whether seized ketamine
has been illicitly manufactured and from which chemi-
cals. These efforts help to provide the evidence to prevent
illicit ketamine manufacture while protecting legitimate
supply chains, thus ensuring the availability of ketamine
for legitimate purposes.
substances. INCB provides and updates the list of psycho-
tropic substances under international control (“Green List”),
forms (P, A/P and B/P) and training material to help com-
petent national authorities to meet the requirements of the
international drug control treaties and the requests con-
tained in the relevant resolutions for the reporting of data.
358. With regard to precursors, the 1988 Convention, in its
article 12, paragraph 12, requires Governments to provide to
the Board information on the amounts seized of internation-
ally controlled precursors and their origin, on any substance
not included in Table I or Table II of that Convention which
is identified as having been used in illicit manufacture of
narcotic drugs or psychotropic substances, and on meth-
ods of diversion and illicit manufacture. Furthermore,
pursuant to resolutions subsequent to the adoption of the
1988 Convention, Governments are requested to provide
to INCB, on a voluntary basis, annual information on the
licit trade in and use of substances listed in Tables I and II
of the 1988 Convention, as well as estimates of their annual
legitimate requirements for imports of selected precursors
of amphetamine-type stimulants. The 1988 Convention
requires the Board to report annually to the Commission
on Narcotic Drugs on the implementation of article 12.
359. To support Governments in complying with the pro-
visions of article 12 of the 1988 Convention with regard to
the monitoring of legitimate international trade in inter-
nationally controlled precursors, the Board developed a
secure web-based tool, PEN Online. Since 2006, the PEN
Online system has facilitated real-time communication
between importing and exporting Governments regarding
planned shipments of precursor chemicals in international
trade, thus contributing to preventing the diversion of such
chemicals into illicit channels.
360. The Board’s Precursors Incident Communication
System (PICS) provides Governments with a platform for
the exchange of real-time information on chemical-related
incidents such as seizures, shipments stopped in transit,
diversions and uncovered laboratories used for the illicit
manufacture of substances and their equipment. PICS has
provided leads for national authorities to initiate backtrack-
ing investigations and, on several occasions, the timely
communication of details of precursor incidents has led
to further seizures or has prevented diversions. PICS also
serves as an early warning mechanism for the identifica-
tion of emerging precursors and the modi operandi used
for diversion, thus informing the Board’s scheduling assess-
ments. Over the past year, a complementary focus of PICS
has increasingly been the exchange of incident information
on equipment used for illicit drug manufacture, with a view
to enhancing the implementation of article 13 of the 1988
Convention (for more details on PICS, see paras.  329–331).
3.
Data collection and analysis
practices of the Board
354. The regular submission of comprehensive and reli-
able statistical data from Governments to the Board is vital
for the overall functioning of the international drug control
system and the analysis of global trends. Good-quality data
provide information that is necessary to not only ensure the
adequate availability of controlled substances for medical
and scientific purposes but also to uncover diversions of
controlled substances for illicit purposes.
355. The Board issues technical reports that provide
Governments with statistical analyses on the manufacture,
consumption, utilization and stocks of and trade in inter-
nationally controlled substances. Those reports are based on
data that parties to the international drug control conven-
tions are obligated to submit and data that Governments
provide voluntarily pursuant to resolutions of the Economic
and Social Council and the Commission on Narcotic Drugs.
On the basis of its analysis, the Board makes recommenda-
tions to competent authorities to ensure the availability of
controlled substances for medical and scientific needs while
preventing their diversion from licit sources.
356. For narcotic drugs, the submission of estimates of
annual licit requirements is mandatory under the 1961
Convention as amended, and the estimates furnished by
Governments need to be confirmed by the Board before
becoming the basis for calculating the limits on manufacture
and import. To ensure that Governments may import nar-
cotic drugs for medical and scientific purposes, estimates
are established by the Board for countries that are unable
to supply them. More information about the obligations
of Governments to comply with the limits on imports and
exports of narcotic drugs can be found in paragraph 104.
357. With regard to psychotropic substances, States par-
ties to the 1971 Convention provide to INCB their annual
statistics on psychotropic substances, as well as voluntary
quarterly statistics on imports and exports of psychotropic
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361. The statistical reports and other data provided by
Governments pursuant to their reporting obligations under
the three international drug control conventions and the
voluntary information provided pursuant to the relevant
resolutions are managed under the INCB International Drug
Control System (IDS), PEN Online and I2ES, the latter two
being web-based platforms that enable countries to engage
in the trade in internationally controlled substances securely
and rapidly.
362. These three systems are currently being updated
to enhance their functionality, in order to better serve the
needs of Member States. One of the main new features of
the updated version of IDS, Next Generation IDS, will be a
web-based portal that will enable Governments to provide
reporting data more rapidly and accurately, track report-
ing errors and review historical data. Next Generation IDS,
which will provide a protected and secure web environment
for Governments, will also have a multilingual interface and
deepened integration with PEN Online and I2ES.
363. In addition to carrying out its mandated functions
under the international drug control treaties, the Board also
assists Governments, through its GRIDS Programme, in
addressing the public health threats posed by the increas-
ing misuse of non-medical synthetic opioids and new
psychoactive substances. Under the GRIDS Programme,
backtracking investigations are supported through IONICS,
which provides national law enforcement agencies with a
secure communication platform for the exchange of real-
time information on seizures, stopped and suspicious ship-
ments and diversion attempts involving new psychoactive
substances, non-medical synthetic opioids and related dan-
gerous substances. A further tool available under the pro-
gramme is the GRIDS Intelligence HD targeting platform,
which enables the development of actionable intelligence for
use by national authorities in conducting targeted interven-
tions. Both tools have, in numerous international investi-
gations, produced results that have directly contributed to
the dismantling of drug trafficking organizations around
the world. The usefulness of IONICS, GRIDS Intelligence
HD and PICS, however, depends largely on whether action-
able information is provided through those tools in a timely
manner and in an amount sufficient to ensure that imme-
diate follow-up can be initiated to identify the traffickers
involved.
364.
The Board urges Governments to enhance their
national mechanisms for monitoring the cultivation,
production, manufacture, and trade of controlled sub-
stances. Recognizing the challenges posed by the poor
quality, irregularity, and often the lack of comprehensive
data, the Board emphasizes the need for robust improve-
ments in national data collection systems.
4. Free trade zones and trafficking in
drugs and precursors
365. Free trade zones, also known as free zones or free
ports, have played a pivotal role in promoting international
trade and economic development across the globe. These
designated areas, often exempt from many of the usual
customs, import and export regulations, facilitate the
movement of goods, foster foreign investment and create
employment opportunities.
366. However, the very factors that make free trade zones
attractive for investment and economic activity also make
them susceptible to misuse for illicit activities, including the
distribution and manufacture of counterfeit goods, money-
laundering and trafficking in tobacco products.
134
While, on
the one hand, the limited supervision, if any, exercised by
customs authorities over shipments of goods from abroad
into free trade zones, or from such zones to foreign coun-
tries, provides for the faster movement of goods, thereby
lowering transaction costs, on the other hand, it allows
contraband to move undetected through those zones. In
general, softened customs controls in free trade zones have
made the zones increasingly vulnerable to a wide range of
abuses by criminal actors.
135
367. Trade involving narcotic drugs, psychotropic sub-
stances and precursors carried out within and through free
trade zones is governed by the international drug control
conventions and related resolutions of United Nations bodies
and by the revised Kyoto Convention on the Simplification
and Harmonization of Customs Procedures.
Free trade zones and the international drug
control conventions
368. The inherent vulnerability of free trade zones to serv-
ing as fertile grounds for trafficking in drugs and precursors
is recognized in the three international drug control con-
ventions. To address situations where limited control or a
lack of control would make it possible for traffickers to use
such zones as convenient depots for their contraband goods
and to smuggle drugs across uncontrolled or insufficiently
controlled borderlines, the 1961 Convention as amended,
in its article 31, paragraph 2, and the 1971 Convention, in
its article 12, paragraph 3 (a), require parties to exercise the
same supervision and control in free trade zones as in other
Kenji Omi, “‘Extraterritoriality’ of free zones: the necessity for
enhanced customs involvement”, WCO Research Paper, No. 47 (Septem-
ber 2019).
134
International Chamber of Commerce and Business Action to Stop
Counterfeiting and Piracy, “Controlling the zone: balancing facilitation and
control to combat illicit trade in the world’s free trade zones” (May 2013).
135
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INCB REPORT 2023
parts of their territories, provided, however, that more drastic
measures may be applied. The commentaries to the two con-
ventions suggest that the conditions often prevailing in free
ports and free zones that may render such zones convenient
for the operations of traffickers indicate the need to apply
even stricter control measures in them than in other areas.
369. Article 18 of the 1988 Convention contains similar
provisions regarding the application by parties of measures
in free trade zones that are no less stringent than those
applied in other parts of their territories, including with
regard to substances in Tables I and II of that Convention,
that is, precursor chemicals. Article 18, paragraph 2, of the
1988 Convention provides for additional measures that
require more intervention by Governments in free trade
zones. These include monitoring the movement of goods
and persons in such zones; empowering competent authori-
ties to search cargoes and incoming and outgoing vessels,
and when appropriate, to search crew members, passengers
and their baggage; establishing and maintaining a system
to detect consignments suspected of containing narcotic
drugs, psychotropic substances and precursor chemicals;
and establishing and maintaining surveillance systems in
harbour and dock areas and at airports and border control
points in free trade zones and free ports.
370. The experience since the adoption of the 1988
Convention has revealed the need for attention to be devoted
to preventing the diversion of precursors within free trade
zones. Reflecting the depth of that concern, the Economic
and Social Council, in its resolution 1992/29, underlined
the importance of applying suitable regulatory measures,
in accordance with the provisions of article 18 of the 1988
Convention, to every stage of the receipt, storage, handling,
processing and delivery of precursor and essential chemicals
in free ports and free trade zones and in other sensitive areas
such as bonded warehouses. Furthermore, in its resolution
1995/20, the Council urged Governments to ensure, as far
as possible, that shipments entering or leaving such zones
be subject, where permitted, to the controls necessary to
safeguard against diversion.
372. Although the revised Kyoto Convention states that
customs authorities shall have the right to carry out checks
at any time on the goods stored in a free zone, there is little
consistency in the application of that provision among free
zones globally. This is perhaps due to misinterpretation of
the aforementioned definition of a free zone, which appears
to confer extraterritorial status on such zones, leading to the
limited involvement and authority of customs authorities.
136
373. Other provisions of the revised Kyoto Convention,
however, provide sufficient evidence to address this mis-
conception. The fact that the Convention provides for the
involvement of customs authorities in relation to require-
ments for the suitability, construction and layout of free
zones, and that those authorities retain the right to carry
out checks at any time on the goods stored in such zones,
indicates that it is only for purposes of duties and taxes that
goods located in the zones are considered as being outside
the customs territory.
374. Furthermore, WCO has issued a publication entitled
“Practical guidance on free zones” to ensure the adequate
global application of customs procedures and surveillance
in free zones. The core elements of the guidance include,
inter alia, the full involvement of customs authorities in free
zones, reporting to customs authorities and the use of data
and information technology systems, customs audits in free
zones, and the authority of customs officials to seize illegal
goods and conduct on-site checks inside free zones.
375. A uniform application of the provisions of the inter-
national drug control conventions and the revised Kyoto
Convention would greatly reduce the chances of free trade
zones being misused for illicit activities. However, few coun-
tries have implemented the provisions of the revised Kyoto
Convention, even though the number of contracting parties
to the Convention has reached 129.
Operation Insight
376. To increase the awareness of the control processes
and procedures of free trade zones, and to better protect
them from being misused for the diversion of and traffick-
ing in precursor chemicals, INCB, WCO and the UNODC-
WCO Container Control Programme jointly implemented
Operation Insight in the period 2022–2023. Designed as
an exercise to understand the processes whereby precur-
sor chemicals enter and exit through free zones, the joint
operation was conducted at a limited number of locations.
Free trade zones and the revised Kyoto
Convention on the Simplification and
Harmonization of Customs Procedures
371. Free trade zones represent an important means for
facilitating trade. The revised Kyoto Convention defines a
“free zone” as a part of the territory of a contracting party (to
the Convention) where any goods introduced are generally
regarded, insofar as import duties and taxes are concerned,
as being outside the customs territory.
136
Omi, “‘Extraterritoriality’ of free zones”.
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377. The preliminary findings of the operation revealed
a lack of uniformity among the participating countries
with regard to the territorial status of free trade zones and
whether and how customs procedures are applied in them.
In some countries, free trade zones were considered to be
part of the customs territory, while in others they were
not. The customs authorities in some countries conducted
risk-based background checks on companies applying for
tenancy in free trade zones and checks on their admis-
sible activities, key employees and compliance records,
while in others they did not. Similarly, divergent practices
were reported regarding the authority of customs officials
to conduct inspections, audits and investigations and to
seize goods within the free trade zones. With regard to the
submission of declarations and related data, the customs
authorities of all participating countries reported having
access to such data, although there were disparities in the
quality of the data. Half of the locations reported that they
had not implemented any cooperation mechanisms with
operators and companies.
378. Although the joint operation was only conducted on
a limited scale, the findings confirm the need for strength-
ening transparency in procedures and mechanisms in free
trade zones. The divergence of practice among countries
with regard to controls over free trade zones and the lower
level of oversight by customs authorities in such zones,
compared to the rest of the territory in which the zones are
located, continue to be reasons for concern, as such factors
make free trade zones vulnerable to exploitation by criminal
organizations, enabling them to traffic drugs and precursor
chemicals through the zones more easily.
Accordingly, the
Board reiterates that States parties to the international
drug control conventions are required to apply drug con-
trol measures in free ports and free zones that are no less
stringent than those applied in other parts of their territo-
ries, and have the option of applying more stringent meas-
ures, as outlined in the conventions.
137
Ensuring that drug
control measures are upheld in free ports and free zones
is imperative to preventing trafficking in internationally
controlled narcotic drugs, psychotropic substances and
precursor chemicals.
5.
Practices and challenges in the
implementation of measures
applied nationally to control non-
scheduled precursor chemicals
379. One of the effects of scrutiny of data on the inter-
national trade in precursor chemicals is the greater atten-
tion given by illicit drug manufacturers to the possibility
of sourcing the same chemicals in domestic markets. The
Board drew attention to this trend in specific chapters of the
INCB reports on precursors for 2020 and 2021.
138
380. In an effort to take stock of existing precursor control
measures applied to domestic markets, the Board conducted
a survey in June 2021 and a follow-up survey in March 2023.
By November 2023, 78 Governments and the European
Commission had responded. Of those respondents, 62 pro-
vided detailed information on specific control measures.
The survey also extended questions about domestic controls
to other internationally non-scheduled chemicals found to
have been used in the illicit manufacture of drugs.
381. Almost 80 per cent of the responding Governments
reported that they had placed other non-internationally
scheduled chemicals under national control, ranging from
1 up to more than 70 chemicals. The Board is also aware that
some countries generically extend the definitions of chemi-
cals under control by including entire families of derivatives
of listed chemicals and other substances closely related to
them. For example, Canada has applied such an approach
to analogues and derivatives of 4-AP, which became subject
to criminal prohibitions under the Controlled Drugs and
Substances Act of Canada in 2022.
382. The survey provided information about the number
of non-scheduled chemicals that have been placed under
international control. The survey revealed that 28 countries
have placed 1 to 10 internationally non-scheduled chemicals
under national control. In addition, three countries have
enacted national controls for 11 to 20 such chemicals, and
four countries have done so for 21 to 30 chemicals.
383. On the basis of the findings of the survey, the Board
identified four key areas for preventing the domestic diver-
sion of non-scheduled precursors from licit to illicit chan-
nels, namely:
(a)
manufacture;
(b)
distribution;
(c)
end uses;
and
(d)
Internet-facilitated trade involving (non-scheduled)
precursor chemicals.
384. The information provided in national responses assists
the Board in updating its information package on the control
Article 31, paragraph 2, of the 1961 Convention; article 12, para-
graph 3 (a), of the 1971 Convention; and article 18 of the 1988 Convention.
137
138
E/INCB/2020/4 and E/INCB/2021/4.
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INCB REPORT 2023
of precursors, enabling enhanced dialogue with Governments
and contributing to policy discussions on measures to address
the proliferation of chemicals not included in Table I and
Table II of the 1988 Convention.
The Board commends all
Governments that have responded and provided important
information on the scope and extent of their national legis-
lation, including domestic controls over substances in both
Table I and Table II of the 1988 Convention and additional
chemicals that are not included in Table I or Table II but
that are under national control.
385. The use of non-scheduled chemicals, including
designer precursors, in illicit drug manufacture is clearly a
major challenge in international precursor control. In order
to increase Governments’ awareness, the Board has pro-
duced several resources and guidance documents, includ-
ing the limited international special surveillance list of
non-scheduled chemicals, which is updated annually, the
Precursor Chemical Monographs and a guidance document
to address the proliferation of non-scheduled chemicals. This
latest document is the result of extensive consultations and
a series of events convened or supported by the Board since
2020, and provides a full range of policy and enforcement
options that Governments can choose to address the challenge
of the use of such non-scheduled chemicals in illicit drug
manufacture. Every year, as part of the information package
circulated to all parties to the 1988 Convention, the Board
also disseminates a compilation of national/domestic meas-
ures that Governments have adopted to control substances.
386. Lastly, in October 2022, the Board also launched PEN
Online Light, an electronic platform similar to PEN Online
that has been designed to allow the sharing of information
about planned exports of precursor chemicals not under
international control. PEN Online Light operates exclusively
on a voluntary basis. Additional information can be found
in paragraph 333.
387. Various industrial sectors that use chemical substances
– whether they are internationally controlled or not – might,
often unknowingly, be exploited by drug traffickers to source
precursors for illicit drug manufacture. Voluntary coopera-
tion with relevant industries is therefore a key element of
effective precursor control. While industries dealing with
known and controlled drug precursors are generally licensed/
regulated by authorities, the categories of industry dealing
with non-scheduled alternative or substitute chemicals not
under international control are less known and may not be
licensed/regulated. In 2022, the Board published a booklet
containing a global review of categories of industry involved
in the manufacture and distribution of and trade in chemi-
cals used in the illicit manufacture of drugs. The booklet aims
to call the attention of Governments to the need to expand
voluntary cooperation with industry to many more actors. In
this connection, the Board is also engaged with partners in
developing methodologies that allow Member States to map
their national industry landscapes, identify potential areas
of intervention and strengthen the proactive and responsible
participation of industry in preventing diversion.
6. Challenges and opportunities in
promoting drug treatment and
rehabilitation according to the
UNODC and WHO International
Standards for the Treatment of Drug
Use Disorders after the COVID-19
pandemic
388. With the slowing down of the global COVID-19
pandemic and with WHO declaring the end of the disease
as a public health emergency in May 2023, Governments
around the world are striving to resume the provision of
public drug use treatment and rehabilitation services to the
most vulnerable populations. Considering the impact of
the pandemic on treatment delivery and services, analysis
of the persisting challenges and innovative approaches to
treatment and rehabilitation can provide valuable input for
the development of future public policies and approaches.
389. The Board has discussed the issue of the provision
of effective treatment services in previous annual reports.
It recently devoted specific chapters to the following topics:
women and drugs (2016); treatment, rehabilitation and
social reintegration for drug use disorders as essential
components of drug demand reduction (2017); improving
substance use prevention and treatment services for young
people (2019); and the hidden epidemic of the use of drugs
among older persons (2020).
390. The COVID-19 pandemic has had a profound impact
on the delivery of treatment services. The strain on health-
care systems and the restriction of movement have disrupted
the conventional methods of treatment in many national
settings. Even before the pandemic, the global landscape of
drug use treatment and rehabilitation services was marked
by disparities, challenges and limitations that necessitated
comprehensive, evidence-based responses. UNODC high-
lighted a substantial gap between the demand for treating
drug-related disorders and actual treatment provision, with
just one in five affected individuals receiving care in 2021.
The pandemic has further exposed these inequities, dispro-
portionately affecting vulnerable demographics.
391. In 2012, a joint statement was issued by 12 United
Nations agencies and programmes, calling on States to close
compulsory drug detention and rehabilitation centres and
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implement voluntary, evidence-informed and rights-based
health and social services in the community. Over 10 years
later, however, many of these centres remain operational.
In some cases, they operate as private clinics with the col-
laboration of patients’ families, as observed in some parts of
South America, or as prison-like facilities run by the State,
outside the control and monitoring of the justice system, as
seen in parts of Asia. In some countries in Africa, they can
be found in hospital settings, and as the result of administra-
tive and financial constraints. A report issued by UNODC
and UNAIDS in 2022 indicated that compulsory drug treat-
ment facilities in East and South-East Asia have not been
closed as planned.
392. The shift in drug use patterns observed in many
regions might have left Governments and communities
unprepared. As a result, owing to the limited availability of
proper treatment services, an increased number of patients
have been directed to compulsory treatment facilities, where
deteriorating conditions have been observed in some coun-
tries. Similarly, overcrowding and inadequate rehabilitation
programmes in prison settings compound challenges, affect-
ing both physical and mental well-being.
393. The provision of non-evidence-based treatment is not
limited to compulsory settings. Many treatment and rehabili-
tation facilities around the world continue to employ inter-
ventions such as physical exercise, forced labour, excessive
use of sedatives, forced religious conversion and punishment
in isolation cells under the guise of “therapy”. This includes
facilities that have been licensed by Governments but that do
not provide their staff with proper training or undergo moni-
toring in line with the UNODC and WHO International
Standards for the Treatment of Drug Use Disorders.
394. According to UNICEF, the pandemic has underlined
the need to strengthen mental health and psychosocial sup-
port for vulnerable populations, especially young people.
In 2022, UNODC reported that young people were using
more drugs than the previous generation, which could be
particularly detrimental to their mental health. For exam-
ple, national mental health plans in Malaysia, Papua New
Guinea, the Philippines and Thailand all emphasized the
need to shift service delivery from institutional, special-
ized clinical treatment to strengthened community-based
services and to place greater emphasis on rehabilitation,
recovery, and social integration and support.
395. Remarkably, the pandemic has not only highlighted
challenges in treatment and rehabilitation, but has also
acted as a catalyst for innovation in treatment services.
For example, the integration of telehealth and technology
has emerged as a promising solution, especially in North
America, overcoming traditional barriers to care and
enhancing patient engagement. Telehealth, shown to be fea-
sible and acceptable, has the potential to provide evidence-
based treatment and support remotely, increasing patient
satisfaction.
396. Advancements in personalized and alternative treat-
ment that have improved the rehabilitation process have
also been observed. Initiatives such as the court diver-
sion programme of Thailand underscore the importance
of alternatives that prioritize rehabilitation over punitive
measures. Such evidence-based programmes align with
UNODC and WHO recommendations for effective drug
disorder rehabilitation.
397. The successful adoption of quality standards was
observed in many countries, reflecting Governments’ efforts
to improve the lives and dignity of patients who use drugs, as
well as the readiness of the United Nations system to support
and promote such endeavours. For example, from 2020 to
2021, two treatment centres in Bolivia (Plurinational State
of) and the Dominican Republic took part in the UNODC
initiative “Quality assurance: facilitating drug dependence
treatment in accordance with the International Standards
for the Treatment of Drug Use Disorders in Latin America”.
In the Plurinational State of Bolivia, an assessment con-
firmed that the evaluated institutions met an average of
86 per cent of the key quality standards. In the Dominican
Republic, 58 per cent of the facilities had medical doctors
specialized in addiction medicine or addiction psychiatry
on staff, with some (48 per cent) offering services for specific
population groups, such as LGBTI individuals.
398. Elsewhere in the Americas, Ecuador has introduced
treatment facilities that offer social support services, includ-
ing education and vocational training assistance (74 per
cent), employment and income generation support (48 per
cent), and housing support (29 per cent). In Guatemala,
most facilities provide motivational enhancement therapy,
group counselling, individual counselling and twelve-step
facilitation, as well as Internet- or web-based therapy. In
Mexico, over half of facilities receive funding from the
Ministry of Health, although only a small number cater
to homeless people (8 per cent), Indigenous groups (6 per
cent), or migrants, displaced persons and refugees (5 per
cent). Overall, capacity for dealing with various types of
drugs has increased, but the provision of specialized medi-
cal care and nursing support remains challenging, as does
gender mainstreaming.
399. In Africa, the scarcity of comprehensive information
and prevalence data continues to hinder efforts to gauge
the full extent of the drug use problem and the availability
of appropriate treatment. According to the latest field test
report in French-speaking African countries prepared by
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INCB REPORT 2023
UNODC, in West and Central Africa, treatment systems
for substance use disorders take the form of Government-
run care centres within the health-care system, outpatient
addiction treatment facilities and various types of hospi-
talization centres. These centres and facilities are mostly
lacking in or provide inadequate opioid agonist treatment,
except for in Côte d’Ivoire, Senegal and Togo. A number
of positive developments have also been identified, such
as the newly established Interministerial Committee for
Combating Drug Abuse and Psychotropic Substances of
Benin. However, the development of services for specific
populations, such as women, children and prisoners, is still
urgently needed in the region.
400.
The Board urges Governments to ensure access
to voluntary, evidence-based treatment services, in line
with the UNODC and WHO International Standards
for the Treatment of Drug Use Disorders. In doing so,
Governments should address systemic disparities and
ensure inclusivity in treatment services, with special
attention given to vulnerable groups. The Board also
encourages Governments to continue to focus on initia-
tives to combat stigma and discrimination in relation to
people who use drugs.
401.
The Board supports the call by UNODC for
Governments to close compulsory treatment facilities
and to shift efforts and resources towards the provision
of evidence-based treatment services and alternatives to
imprisonment.
402.
The Board encourages Governments to continue
collaborating with the international community to
strengthen management and monitoring capacities, as
well as data collection and data-sharing, to inform and
improve public policies and the provision of treatment
and rehabilitation services.
403.
Lastly, the Board urges Member States to imple-
ment continuous review mechanisms directed at licensed
treatment facilities in their territories, with the aim
of ensuring compliance with the UNODC and WHO
International Standards for the Treatment of Drug Use
Disorders.
globe, including deforestation, contamination of rivers and
soil, and animal and human poisoning. Indirectly, the illicit
production, manufacture and trafficking of drugs can also
be linked to other environmentally damaging activities,
such as illicit mining. The impact of those activities often
affects local communities most adversely, as it may destroy
livelihoods and introduce violence and drug use to popula-
tions in remote areas. While the connection between illicit
drug-related activities and environmental consequences still
requires further research, there is growing evidence showing
that there are significant linkages at play.
405. The illicit cultivation of drug crops occurs predomi-
nantly in remote and ecologically fragile areas, resulting in
significant impacts on local ecosystems and biodiversity.
According to UNODC, the tropical forests of Nigeria have
become hubs for illicit cannabis cultivation, causing profound
shifts in their ecological dynamics. Similarly, the Andean
region has witnessed the expansion of illicit coca cultivation
leading to substantial deforestation, soil degradation and loss
of floral and faunal diversity. The Amazon basin, a biodiver-
sity hotspot, faces threats due to illicit coca cultivation, with
varying degrees of forest loss occurring across countries. In
the Golden Triangle of South-East Asia, illicit opium poppy
cultivation has played a pivotal role in forest degradation. In
certain areas of Afghanistan, such as the southern province of
Helmand, opium poppy cultivation has resulted in saliniza-
tion because of poor drainage during irrigation.
406. Illicit drug production makes use of noxious chemi-
cals that percolate into the environment, yielding widespread
and harmful contamination. For instance, methampheta-
mine synthesis involves the use of hazardous chemicals,
such as anhydrous ammonia, that are often disposed of in
the environment without being properly treated. Within the
relatively small geographic area comprising the southern
areas of the Kingdom of the Netherlands and the northern
areas of Belgium, the concentration of dumping sites associ-
ated with synthetic drug production has led to significant
soil and water contamination. Similarly, cocaine production
in the Andean Amazon region employs substances such as
sulfuric acid and kerosene, triggering ecological disruptions.
Although the risks posed to public health and biodiversity
by such activities may be relatively small in global terms,
they may be significant at the local level.
407. The carbon footprint of illicit drug production has
alarming implications for climate change. For example,
according to statistical data provided by UNODC, the
manufacture of cocaine produces significant carbon emis-
sions, an estimated 8.9 million tons of carbon dioxide per
year. It takes more than 300 litres of gasoline to produce 1 kg
of cocaine, with legacy impacts ranging from water pollu-
tion to soil degradation, which have implications for both
7.
The impact of drug-related crimes
on the environment
404. The intricate interplay between illicit drug econo-
mies and environmental degradation has emerged as a
pressing concern, demanding comprehensive scrutiny and
concerted action. The impact of illicit drug-related activi-
ties on the environment takes different forms around the
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
61
animal and human health. The process of illicit drug pro-
duction, characterized by inadequate waste management in
remote locations, exacerbates its carbon emissions impact.
In Cambodia and Myanmar, the utilization of precursor
chemicals in the illicit manufacture of synthetic drugs has
created a specific negative impact on the fragile ecosystems
of those countries due to the large amount of wood required
in the process. Additionally, illegal gold mining and crypto-
currency mining (involving massive energy consumption
for computing), often intertwined with drug trafficking, play
a pivotal role in increasing deforestation and augmenting
carbon emissions within the Amazon region.
408. Drug trafficking is connected to various forms of
environmental exploitation. In Central America, drug car-
tels seamlessly diversify into illegal logging, illegal mining,
and trafficking in wildlife. Notably, those activities are
frequently accompanied by a range of convergent crimes,
from bribery to violent crimes. Research in Central America
indicates that drug trafficking can indirectly drive land-use
changes by facilitating deforestation through illicit capital
and land control practices, potentially resulting in greater
environmental impacts than those caused by the direct
actions of drug trafficking networks.
409. In Ecuador, the deterioration of the environment and
the degradation of natural resources due to coca bush cul-
tivation and cocaine production pose threats to vulnerable
livelihoods at the northern border with Colombia, especially
for those who depend economically on the harvest of shells
and crabs. This situation has the potential to push local vul-
nerable populations into the illicit economy, including the
activities of cocaine smuggling or smuggling subsidized
gasoline to cocaine traffickers in the department of Nariño
in Colombia for use in cocaine manufacture.
410. In Mexico, the confluence of illicit cannabis and opium
poppy cultivation converges with the unlawful logging trade,
particularly afflicting the Sierra Madre Occidental region.
Across the Amazon basin, violent disputes between local
communities and drug traffickers are routinely reported,
often a result of complaints over land speculation and illegal
occupation. The triple border area of Brazil, Colombia and
Peru is a hotspot of illicit deforestation, driven by the illegal
timber trade, as well as drug trafficking.
411. In Africa, increased law enforcement activities along
traditional drug supply routes have shifted distribution pat-
terns, with West Africa emerging as a significant hub. For
instance, in Nigeria, outdoor cannabis cultivation processes
involve labour-intensive tasks such as clearing, planting and
harvesting, potentially resulting in greenhouse gas emis-
sions from fuel and electricity use. Additionally, armed
groups associated with drug trafficking also engage in illicit
activities such as elephant poaching and ivory trafficking,
further impacting on the continent’s landscapes and wildlife.
412. Efforts to eradicate illicit drug crops often have unin-
tended environmental consequences. Aerial spraying of her-
bicides, such as glyphosate, can harm non-target species
and result in soil and water contamination. In its report
on human rights challenges in addressing and countering
all aspects of the world drug problem,
139
issued in August
2023, OHCHR confirmed that risks are posed by the aerial
spraying of pesticides and other chemicals to the environ-
ment and the health of the affected population, and recom-
mended that States and relevant stakeholders avoid aerial
spraying for crop eradication and ensure that the eradication
of illicit crops does not negatively affect the environment or
the health of individuals.
413. In the report, OHCHR further recognized that some
of the most prominent effects of illicit drug economies, such
as deforestation, monocultures, pollution of waters and soil,
and the high carbon footprint of in-house cultivation, pose
a risk to access to a clean and healthy environment, which
was recognized as a universal human right by the General
Assembly in 2022.
140
This is evidenced, for example, in
Colombia, where drug-related violence and displacement
are intertwined, and eradication efforts can trigger further
deforestation due to land-use changes, and in Myanmar,
where analogous efforts aimed at eradicating opium poppy
cultivation have caused soil erosion and the concomitant
loss of indigenous agroforestry practices.
414. Striking a balance between addressing drug-related
crime and minimizing environmental harm remains a com-
plex challenge. Addressing the environmental impact of the
illicit drug trade requires a holistic approach. International
cooperation is essential, given the potential of drug-related
crime to undermine ecosystems and human well-being.
Coordinated responses encompass comprehensive law
enforcement efforts, environmental protection measures
and sustainable development strategies.
415.
The Board calls on Governments, with the support
of the international community, to take urgent action to
address such threats, prioritizing the safety and well-
being of local, native and vulnerable populations, as
well as the protection of the environment. Furthermore,
the Board urges Governments to collaborate with the
international community and with the United Nations
system in improving the available research and data on
the dynamics of illicit drugs and the environment and the
related impacts across all regions of the globe.
139
140
A/HRC/54/53.
General Assembly resolution 76/300.
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INCB REPORT 2023
B. Africa
The Board notes with concern the insufficient availability
of narcotic drugs and psychotropic substances for medical
use in Africa and reiterates the importance of improving
the availability of and access to internationally scheduled
substances for medical purposes.
The role of Africa, in particular West and Central Africa, as
a transit region for cocaine has expanded significantly, as
corroborated by seizures, which reached an all-time high
in 2021.
Trafficking in and abuse of tramadol, a synthetic opioid not
under international control, are of growing concern in a
number of African countries.
While assessing the extent of drug misuse and accurately
estimating the number of people receiving treatment on the
continent remain a challenge, the Board recognizes that
Governments in the region are making progress in address-
ing substance use disorders.
419. The African Union Plan of Action on Drug Control
and Crime Prevention (2019–2023), the fifth strategic
framework that guides drug policy development in Africa,
has been extended by Heads of State to 2025. The action
plan is aimed at improving the health, security and socio-
economic well-being of the people of Africa by addressing
drug trafficking and problematic drug use in all its forms
and manifestations and preventing the onset of drug use.
420. The Board continues to assist countries in meeting
their reporting obligations under the three international
drug control conventions, as well as in addressing their drug
control challenges. The initiatives conducted by the Board
within the framework of INCB Learning and the INCB
GRIDS Programme can be found in paragraphs 422–425,
427–428, 430–432 and 434–437.
2.
Regional cooperation
1.
Major developments
416. Drug control efforts and the availability of and access
to internationally scheduled substances for medical pur-
poses in countries in Africa continued to be affected by
political instability, economic challenges and ongoing con-
flicts in parts of the region.
417. The role of Africa, in particular West and Central
Africa, as a transit region for cocaine trafficking from South
America to Europe has expanded significantly. In 2021, sei-
zures of cocaine in Africa reached an all-time high in terms
of both quantities of the drug seized as well as the number
of seizures. While West Africa accounted for most of the
cocaine seized, there are indications that other parts of the
continent have also been affected.
418. The number of countries in Africa that permit the
cultivation of cannabis for medical or scientific purposes
has been growing in recent years. Some of the countries
permit cultivation only for export, while others allow the
use of cannabis for medical purposes domestically. For 2024,
12 countries in Africa submitted their estimates to the Board
for the cultivation, production or consumption of cannabis
for medical and scientific purposes.
421. Since 1 November 2022, the Conference of the States
Parties to the African Medicines Agency Treaty, the high-
est policymaking body of the Agency, has convened several
extraordinary sessions to further accelerate the Agency’s
operationalization. In particular, the meetings considered
the staffing structure of the Agency and the contribution by
States parties to its budget. The meetings also adopted the
revised terms of reference of the Agency’s Director General
and appointed the members of the Governing Board.
422. On 7 and 8 November 2022, the INCB GRIDS
Programme, in partnership with the UNODC Container
Control Programme, organized a training event in Morocco
for customs officers on awareness-raising and safe handling
practices related to new psychoactive substances, synthetic
opioids and other dangerous substances. The training also
strengthened information exchange using the IONICS and
GRIDS Intelligence high-definition targeting tools. In addi-
tion, it covered precursors-related aspects and platforms,
including PEN Online, PEN Online Light and PICS.
423. On 8 and 9 November 2022, the INCB GRIDS
Programme organized a training event in the Democratic
Republic of the Congo for postal and customs officers. The
training focused on awareness-raising and safe handling
practices related to new psychoactive substances, synthetic
opioids and other dangerous substances, and also strength-
ened information exchange using the IONICS and GRIDS
Intelligence high-definition targeting tools.
424. From December 2022 to January 2023, Benin,
Cameroon, Côte d’Ivoire, Ghana, Guinea, Mauritius,
Namibia, Nigeria, Senegal, Sierra Leone and Zambia par-
ticipated in the Board’s Operation Knockout and exchanged
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
63
intelligence to identify and dismantle illicit manufacturing
and distribution points involving non-medical carisoprodol,
1,4-butanediol, flubromazepam,
gamma-butyrolactone
and
ketamine trafficked through the international post, express
mail, courier services and related modalities.
425. From 23 to 27 January 2023, the INCB GRIDS
Programme delivered an awareness-raising and capacity-
building workshop on the safe interdiction of synthetic
opioids and related chemicals for frontline officers from
Benin, Côte d’Ivoire and the Niger, in partnership with
the UNODC Nigeria Organized Crime: West African
Response to Trafficking project. The workshop was aimed
at strengthening information exchange in the region to aid
in counter-trafficking efforts related to synthetic opioids and
new psychoactive substances using IONICS and GRIDS
Intelligence high-definition targeting tools.
426. In February 2023, the Eastern and Southern Africa
Commission on Drugs was established, following the model
of the West Africa Commission on Drugs, to review current
policies, promote science-based drug policies and mobilize
public awareness of drug issues in Eastern and Southern
Africa.
427. From 21 to 23 February 2023, the INCB GRIDS
Programme organized an online stakeholder consultation
on voluntary cooperation between Governments and freight
forwarding services for the prevention of trafficking in dan-
gerous substances. The event was attended by representa-
tives from the public and private sector, including Kenya,
and international organizations. Participants exchanged best
practices and shared case examples related to the exploita-
tion of legitimate ancillary logistics services, and discussed
the next steps for promoting voluntary cooperation between
Governments and their private sector partners.
428. On 21 and 22 March 2023, the INCB GRIDS
Programme, in partnership with the UNODC Container
Control Programme, conducted capacity-building training
in Tunisia for 20 customs officers on the safe interdiction
of synthetic opioids and related chemicals and on strength-
ening intelligence exchange using IONICS and GRIDS
Intelligence high-definition targeting tools. A second
course was conducted by the INCB GRIDS Programme
on 23 March 2023 for nine health regulatory officers at the
headquarters of the Tunisian Ministry of Health.
429. On 26 March 2023, the UNODC Regional Office for
the Middle East and North Africa signed its new Regional
Framework for Arab States (2023–2028) in cooperation
with the League of Arab States and its 18 member States,
including the following African countries: Algeria, Egypt,
Libya, Morocco, Sudan and Tunisia. The regional framework
focuses on the following areas:
(a)
taking a balanced
approach to drug control;
(b)
strengthening the response
to organized crime;
(c)
combating trafficking in persons and
smuggling of migrants;
(d)
taking action against corruption
and financial crime;
(e)
preventing and countering terror-
ism and violence; and
(f)
strengthening crime and violence
prevention and criminal justice. On the same occasion, the
Arab Plan for Prevention and Reduction of the Dangers of
Drugs to Arab Society: Towards Effective Handling of the
Issue from a Social Perspective was signed, representing a
regional social framework for combating drugs in the Arab
States.
430. On 26 and 27 April 2023, the INCB GRIDS
Programme hosted a capacity-building training course in
Morocco for enforcement officers from the police, the cus-
toms administration, the Royal Moroccan Gendarmerie and
the Directorate of Migration and Border Surveillance. A
second course was held on 29 April 2023 at the Moroccan
Post headquarters. Both events focused on enhancing
knowledge and skills to identify and safely interdict dan-
gerous substances. Participants also received instruction on
IONICS and GRIDS Intelligence high-definition targeting
tools to improve cross-border intelligence-sharing.
431. From 12 to 16 June 2023, the INCB GRIDS Programme
organized an interregional twinning event for trust-building,
relationship development and active networking for offic-
ers from police, customs and regulatory agencies of Ghana,
Nigeria, Thailand and Viet Nam, as well as the regional
World Customs Organization (WCO) Regional Intelligence
Liaison Office.
432. From 4 to 7 July 2023, the INCB GRIDS Programme
organized a twinning event for police, customs and postal
security officers from Cameroon and the Congo, held in
Yaoundé. The event focused on trust-building and network-
ing for officers, and provided them with practical knowledge
and skills to identify and safely interdict dangerous sub-
stances. Participants also received instruction on IONICS
and GRIDS Intelligence high-definition targeting tools to
improve cross-border intelligence-sharing.
433. From 19 to 22 July 2023, the African Union held the
Continental Technical Experts’ Consultation on Synthetic
Drug Supply Reduction in Abidjan, Côte d’Ivoire, with the
participation of some 70 experts from about 35 countries.
The meeting was aimed at enhancing knowledge of current
trends in synthetic drug trafficking in Africa, promoting
inter-agency collaboration and strengthening mechanisms
for real-time intelligence exchange. Experts were given
information about the Pan-African Epidemiology Network
on Drug Use supply reduction data-collection tool and
about sharing best practices for information exchange for
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INCB REPORT 2023
interdiction operations. The INCB President participated in
the event and delivered a statement, stressing the opportuni-
ties afforded by enhancing efforts for coordination, timely
data-sharing and use of existing systems and platforms,
including those offered by the Board, such as PEN Online,
PEN Online Light, PICS and IONICS.
434. From 2 to 4 August 2023 the INCB GRIDS Programme
conducted a regional expert group meeting on the preven-
tion of trafficking in new psychoactive substances and non-
medical synthetic opioids through freight forwarding and
third-party logistics services in Central and West Africa.
The event took place in Lagos, Nigeria, and was attended
by participants from the Congo, Côte d’Ivoire, Nigeria and
Senegal, as well as the Universal Postal Union, and WCO.
435. From 11 to 15 September 2023, the INCB GRIDS
Programme organized in Vienna the sixth annual opera-
tional meeting on countering trafficking in dangerous syn-
thetic drugs and chemicals through postal, courier and air
cargo services. The event brought together officers from 32
Governments and international organizations, including
participants from Nigeria and South Africa. Several par-
ticipating Governments also conducted bilateral and mul-
tilateral case meetings – facilitated by INCB – to enhance
cooperation across borders.
436. Drug control officials from the competent national
authorities of 39 countries in Africa, namely Algeria,
Angola, Botswana, Burkina Faso, Burundi, Cabo Verde,
Cameroon, Comoros, Côte d’Ivoire, the Democratic
Republic of the Congo, Djibouti, Egypt, Eritrea, Eswatini,
Ethiopia, Gabon, Ghana, Guinea, Kenya, Lesotho, Liberia,
Libya, Madagascar, Malawi, Morocco, Mozambique, the
Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Africa,
the Sudan, Togo, Tunisia, Uganda, the United Republic of
Tanzania, Zambia and Zimbabwe, have registered to use
INCB Learning e-modules. There are now five e-modules
that have been developed by INCB Learning, covering
narcotic drugs, psychotropic substances, precursors, the
international drug control framework and methods for
ensuring the adequate availability of controlled substances
for medical and scientific purposes. E-modules are available
to officials of competent national authorities at no cost upon
registration through INCB Learning.
437. From 20 to 22 September 2023, a twinning event for
trust-building, relationship development and active net-
working to increase awareness on trafficking in synthetic
opioids, fentanyl-related substances and new psychoactive
substances in West and Central Africa was held in Côte
d’Ivoire. The event also included training on intelligence
development and sharing through the IONICS and GRIDS
Intelligence high-definition targeting tools and brought
together officers from the WCO Regional Intelligence
Liaison Office for Western and Central Africa, WCO
national focal points from Cameroon, the Central African
Republic, Côte d’Ivoire, Senegal and Togo, as well as the
Cameroon postal service.
3.
Availability of internationally
controlled substances (including
reporting to the Board)
438. The three international drug control treaties require
the States parties to furnish statistical reports to the Board
on an annual basis. These reports enable the Board to moni-
tor the licit commerce of narcotic drugs and psychotropic
substances as well as monitor availability of these substances
for licit medical and scientific purposes.
439. Over the last 20 years, the level of consumption
of internationally controlled opioid analgesics in Africa,
expressed in S-DDD per million inhabitants, has followed a
fluctuating trend at a generally lower level as compared with
other regions, ranging between a low of 1,355 S-DDD
pm
in 2013 and a high of 4,514 S-DDD
pm
in 2020. However,
the amount reported decreased to 2,556 S-DDD
pm
in 2021.
Of that amount, about half (1,238 S-DDDpm) related to
fentanyl, 1,115 S-DDD
pm
to morphine, 135 S-DDD to
pethidine, 51 S-DDD
pm
to oxycodone and smaller quanti-
ties to other less common opioids. The data on consumption
are not provided on a regular basis by all countries in the
region and therefore one country not reporting one year
could significantly impact the regional total. Most prob-
ably, the fluctuation in the data is due to gaps in reporting
rather than large fluctuations in actual consumption. The
countries with the highest consumption of opioid analgesics
in S-DDD terms were South Africa (827 S-DDD
pm
), Tunisia
(545 S-DDD
pm
), Seychelles (239 S-DDD
pm
), Mauritius
(231 S-DDD
pm
), Egypt (174 S-DDD
pm
) and Cabo Verde
(103 S-DDD
pm
). More than 29 countries in Africa did not
provide any data on the consumption of medicines contain-
ing opioid analgesics.
440. About two thirds of the countries and territories
of Africa have regularly provided their annual statistical
report on psychotropic substances as required under the
1971 Convention. Of the remaining countries and territories
in the region, some have provided the required report at
least once in the past five years, with the remaining failing
to provide their statistical report at all in the past five years.
441. It remains challenging for the Board to determine
the levels of consumption of psychotropic substances in
Africa as approximately half of the countries and territories
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in the region have not provided consumption data to the
Board on any psychotropic substance for the past five years.
Determining availability is also hampered by the signifi-
cant proportion of countries in the region failing to regu-
larly provide their annual statistical report on psychotropic
substances.
442.
The Board stresses that there is insufficient avail-
ability of narcotic drugs and psychotropic substances in
the region and emphasizes the importance of ensuring
sufficient availability of and access to internationally
controlled substances for medical purposes. The Board
encourages the countries and territories in Africa that
have not provided the reports as required under the inter-
national drug control conventions to do so as soon as pos-
sible and take the necessary measures to ensure that their
respective competent national authorities have sufficient
resources to prepare the reports in a timely manner, in
particular on consumption of psychotropic substances.
443. As regards precursor chemicals, Member States vol-
untarily provide – in the context of resolution 49/3 of the
Commission on Narcotic Drugs – their estimates of their
annual legitimate requirements for imports of certain pre-
cursor chemicals frequently used in the illicit manufacture
of amphetamine-type stimulants. Among other substances,
the provision of annual legitimate requirement estimates is
requested for ephedrine and pseudoephedrine, which are
substances that also have medicinal uses, as well as, to the
extent possible, for preparations containing those substances
that could be easily used or recovered by readily applicable
means.
444. Out of the 54 countries on the African continent, 41
(76 per cent) provided the Board with at least one estimate
of their annual legitimate requirements for imports of ephe-
drine, pseudoephedrine or their preparations. However,
approximately 17 per cent of them have not updated their
estimates for the above-listed substances in the past 10 years;
this undermines the potential of annual legitimate require-
ment estimates as a tool to guide exporting countries as
to the legitimate requirements of importing countries in
order to prevent oversupply and diversion into illicit chan-
nels as well as ensure the availability of those substances for
legitimate purposes. Six African countries have provided
annual legitimate requirement estimates to the Board for the
first time in the last five years. Those countries are Gabon,
Lesotho, the Niger, Sierra Leone, South Sudan and Togo.
445. Further information can be found in the technical
reports of the Board on narcotic drugs,
141
psychotropic
substances
142
and the implementation of article 12 of the
1988 Convention.
143
The publication entitled
Guide on
Estimating Requirements for Substances under International
Control,
developed by INCB and WHO for use by compe-
tent national authorities, and the document entitled “Issues
that Governments may consider when determining annual
legitimate requirements for imports of ephedrine and pseu-
doephedrine” are available on the Board’s website.
4. National legislation, policy and
action
446. The Government of Algeria enacted Law 23-05 of
7 May 2023, amending and supplementing Act No. 04-18
of 25 December 2004 on preventing and combating the use
of and trafficking in narcotic drugs and psychotropic sub-
stances. The law provides penalties for various drug-related
offences. It also provides for the development of a national
strategy.
447. In January 2023, Botswana established a new Drug
Enforcement Agency under the auspices of the Ministry of
Defence and Security. The agency is mandated to collect and
disseminate information on the illicit use of narcotic drugs
and psychotropic substances as well as to receive and inves-
tigate any complaints of an alleged or suspected breach of
the law. The agency will also advise Government ministries
and departments, public bodies, institutions, companies,
statutory bodies and corporations on ways and means of
preventing prohibited activities relating to narcotic drugs
and psychotropic substances.
448. On 26 June 2023, the Government of Ghana launched
the National Drug Control Master Plan. The plan seeks to
conceptualize and develop a comprehensive strategy for
addressing the challenges associated with the production,
cultivation, trafficking, sale, distribution and use of narcotic
drugs in the country. The plan is built on six strategic pil-
lars:
(a)
supply reduction;
(b)
demand reduction;
(c)
harm
reduction;
(d)
cooperation and collaboration;
(e)
research;
and
(f)
capacity-building.
449. On 12 July 2023, the Parliament of Ghana passed
the Narcotics Control Commission Amendment Bill 2023,
introducing changes to the controls that apply to the cultiva-
tion of cannabis for industrial and medicinal purposes. The
amended bill granted the Ministry of Interior the author-
ity to issue licences for the cultivation of cannabis in the
country.
142
141
E/INCB/2023/3.
E/INCB/2023/4.
E/INCB/2023/2.
143
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INCB REPORT 2023
450. On 18 November 2022, the Government of Mauritius
amended the Dangerous Drugs Act 2000. The amendment
contains provisions on how medical cannabis will be regu-
lated and dispensed. It also contains provisions related to
alternatives to conviction or punishment as well as rehabili-
tation of drug users.
451. On 21 March 2023, the Senate of Nigeria passed
amendments to the National Drug Law Enforcement
Agency Act. The amendments aim to strengthen the opera-
tions of the Agency, empower it to establish laboratories to
carry out scientific investigations and analysis of controlled
substances, update the list of dangerous drugs, review pen-
alty provisions, enhance the power of the Agency to pros-
ecute drug-related offences and issue subsidiary legislation
on related matters. On 6 June 2023, the National Drug Law
Enforcement Agency (Amendment) Act, 2023, was read the
third time and passed into law.
452. In 2022, as a result of the Board’s twinning initia-
tive aimed at promoting industry cooperation in the area of
precursor control, the Government of the United Republic
of Tanzania adopted a voluntary code of practice to fur-
ther enhance the concept of public-private partnership in
the country. The voluntary code of conduct complements
the signing of a memorandum of understanding between
the competent national authorities in the United Republic
of Tanzania and members of the industry, including two
pharmaceutical associations and a number of companies,
in 2021.
453. On 14 December 2022, the Government of South
Africa enacted the Drugs and Drug Trafficking Amendment
Act No. 14 of 2022, amending the Drugs and Drug
Trafficking Act No. 140 of 1992. The amended act crimi-
nalizes the manufacturing and supplying of any substance
included in Schedule 1 to the Act (“substances useful for the
manufacture of drugs”); and the use, possession and dealing
in any drug included in Schedule 2 to the Act (“dependence-
producing substances” as well as “dangerous dependence-
producing substances”). The Cabinet member responsible
for the administration of justice, the Minister, may, by notice
in the Government Gazette, amend Schedules 1 and 2 to
the Act.
454. On 22 August 2023, the Parliament of Uganda passed
the Narcotic Drugs and Psychotropic Substances (Control)
Bill, 2023, following an annulment by the Constitutional
Court on 5 May 2023 due to the lack of a quorum. The bill
allows cultivation of cannabis and khat strictly for medical
and other authorized uses and sets penalties for a multitude
of offences related to substances abuse.
5.
Cultivation, production,
manufacture and trafficking
455. The number of countries in Africa that permit culti-
vation of cannabis for medical and scientific purposes has
been growing. Some of the countries permit cultivation only
for export, while others allow the use of cannabis for medi-
cal purposes domestically. For 2024, 12 countries in Africa
submitted their estimates to the Board for the cultivation,
production or consumption of cannabis for medical and
scientific purposes, compared with 10 countries that submit-
ted such estimates for 2023.
456. The role of Africa as a transit region for trafficking
in drugs as well a target market has grown significantly in
recent years. The following paragraphs illustrate this phe-
nomenon for different drugs and different countries.
457. Trafficking in cannabis and cannabis resin remains
concentrated in North Africa, although cannabis seizures
are reported from countries across the continent. The avail-
able data suggest that the quantities of cannabis seized,
particularly in Algeria and Morocco, continued to drop in
2022. For 2022, Algeria reported seizing 58 tons of cannabis
resin (compared with 71 tons in 2021) and 5 kg of cannabis
herb (compared with 8 kg in 2021). For the same period,
Morocco reported seizing over 300 tons of cannabis resin
in 2022 (compared with over 511 tons in 2021) and about
209 tons of
kif,
a dried material derived from cannabis (com-
pared with 328 tons in 2021). The quantities of seized canna-
bis herb reported by the authorities of Egypt also decreased,
from over 466 tons in 2021 to 368 tons in 2022, while the
quantities of cannabis resin seized in the country in 2022
were higher than in the previous years (over 49 tons in
2022, 28 tons in 2021, over 44 tons in 2020, and over 39 tons
in 2019).
458. In 2023, countries in North Africa continued to seize
high volumes of cannabis in transit to Europe or destined
for the North African market. In March and April 2023,
the authorities of Algeria reported seizing over 2.5 tons of
kif. In the first trimester of 2023, the Moroccan authorities
reported seizing 24 tons of cannabis resin and 49 tons of
cannabis herb. One incident in the port of Tangier involved
nearly 5.5 tons of cannabis seized, along with 60 kg of
cocaine; the substances, which were discovered hidden in a
refrigerated container, were destined for Europe. Additional
data on cannabis seizures for 2023 have so far been limited,
which makes comparison with previous years difficult.
459. In 2022, trafficking in cocaine was reported across
the continent. Algeria, Benin, Botswana, Burkina Faso,
Cameroon, Côte d’Ivoire, the Democratic Republic of
the Congo, Egypt, Eswatini, the Gambia, Ghana, Guinea,
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Guinea Bissau, Kenya, Lesotho, Liberia, Madagascar,
Malawi, Mali, Mauritania, Mauritius, Morocco, Namibia,
the Niger, Nigeria, Senegal, South Africa, Togo, Tunisia, the
United Republic of Tanzania and Zambia reported seizures
of the drug in quantities ranging from a few grams to sev-
eral tons. The largest quantities – over two tons each – were
reported by Côte d’Ivoire, Guinea and Nigeria, all located
along the Gulf of Guinea.
460. In the first half of 2023, countries in Africa contin-
ued to report large seizures of cocaine, thus indicating that
trafficking in this drug remains a major challenge in the
region. In April 2023, the Guinean navy seized more than
1.5 tons of cocaine from a Sierra Leone-flagged vessel. The
drug was believed to be ultimately destined for markets in
Europe. The authorities of Senegal seized over 800 kg of
cocaine on a vessel 335 km off Dakar in January 2023. In
February 2023, Libyan customs officers seized in the port
of Al-Khoms 269 kg of cocaine that had been hidden in
a container originating in Brazil. According to the Libyan
authorities, this was one of the country’s largest seizures of
cocaine. In February 2023, the authorities of South Africa
seized 380 kg of cocaine in Durban harbour. In addition to
maritime seizures, South African authorities also reported
cocaine seizures at the airport, including 140 kg of cocaine
found on business premises situated in an industrial area
close to the airport.
461. The UNODC
Global Cocaine Report 2023: Local
Dynamics, Global Challenges
commented that the role of
Africa, in particular West and Central Africa, as a transit
region for cocaine trafficking from South America to Europe
has significantly expanded. This development has report-
edly contributed to increased demand for cocaine on local
markets; however, the lack of official data from the countries
in the region continues to present an impediment to a clear
understanding of the precise extent of use of that drug in
Africa.
462. According to a transnational organized crime threat
assessment for Nigeria, conducted by UNODC, Nigeria
remains a transit hub for transnational cocaine and heroin
trafficking. The report also indicates that criminal networks
from Nigeria play an important role in drug trafficking and
smuggling activities on the African continent as well as
globally.
463. In 2022, the UNODC-WCO Container Control
Programme in Eastern and Southern Africa reported
204 seizures, including 10 kg of heroin, 20 kg of khat and
4,605 litres of chemical precursors. The Container Control
Programme units in West Africa made 34 seizures, includ-
ing 216 kg of cocaine and 9,462,110 pieces of unspecified
medical products.
464. While trafficking by sea continues to be the primary
means of arrival for illicit drugs entering or transiting across
the continent, trafficking by air also presents challenges in
the region. From 2021 and up until 1 June 2023, the joint
airport interdiction task forces in Africa seized 413 kg of
cocaine, 293 kg of khat, 782 kg of cannabis, 178 kg of heroin,
127 kg of psychotropic substances and 102 kg of precursors,
as well as 297.6 kg of falsified medicines. Airports in Kenya
and Ethiopia are also believed to have been targeted as stop-
overs points for cocaine from Brazil destined for Europe.
465. Trafficking via international postal services, observed
in particular during the COVID-19 pandemic, continues
to be an important trend in the region, notably for cocaine
bound for Europe.
466. As regards trafficking of pharmaceutical opioids,
the UNODC
World Drug Report 2023
indicates that Africa
accounted for half of the quantities seized worldwide
between 2017 and 2021. This was reportedly mainly due
to the non-medical use of tramadol, a synthetic opioid not
under international control which remains a threat, in par-
ticular in North, West and Central Africa, including the
Sahel region. Trafficking in tramadol continued in 2022
with Algeria, Benin, Burkina Faso, Cameroon, the Central
African Republic, Côte d’Ivoire, Egypt, the Gambia, Ghana,
Guinea, Nigeria, Senegal, Togo and the United Republic
of Tanzania all reporting seizures of the substance. Data
for 2023 have so far been limited. In the first half of 2023,
the National Drug Law Enforcement Agency of Nigeria
reported some large seizures of tramadol, including over
3 million tablets seized in January 2023 in a warehouse and
more than 1.2 million tablets seized during two operations
in March 2023.
467. Trafficking in heroin continues to pose a challenge in
the region. While the East African subregion is mainly used
as an entry point for heroin from South-West Asia, the drug
is trafficked through all subregions to reach consumer mar-
kets. For 2022, Algeria, Benin, Burkina Faso, Côte d’Ivoire,
Egypt, the Gambia, Mauritius, Morocco, Namibia, Nigeria,
Senegal, South Africa, Togo and the United Republic of
Tanzania reported seizures of the substance. In particular,
South Africa continues to report large seizures of heroin.
In July 2023, the Trilateral Planning Cell established by the
authorities of Mozambique, South Africa and the United
Republic of Tanzania to counter heroin trafficking through
the southern route seized 250 kg of the substance at the
border with Mozambique. The quantity of this single sei-
zure is more than double the amount of heroin seized in
the country in 2022 (over 106 kg). The drug was hidden in
a concealed compartment of a truck.
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INCB REPORT 2023
468. Information regarding trafficking in other drugs
is limited. However, several countries in the region
reported seizing amphetamine, ketamine, khat, MDMA,
methaqualone or methamphetamine in the course of 2022.
469. Although the information from the region is lim-
ited, the Board is aware that some countries in the region
have recently been targeted by traffickers seeking alternative
sources of supplies of amphetamine-type stimulant precur-
sors, in particular pharmaceutical preparations containing
pseudoephedrine. To address the situation, the Board has
facilitated the exchange of actionable information and notes
the efforts of the countries concerned in this regard.
470. More generally, and as in previous years, only a few
countries in Africa have submitted to the Board the manda-
tory information for 2022 related to seizures of precursor
chemicals, both the substances in Tables I and II of the 1988
Convention and chemicals not under international control.
Such information is crucial for identifying emerging trends
in precursor trafficking as well as weaknesses in precursor
control systems.
471.
The Board wishes to remind Governments of their
obligation under the 1988 Convention to provide it with
information related to seizures of substances scheduled at
the international level and of substances not under inter-
national control, including, when known, their origin.
472. A comprehensive review of the situation with respect
to the control of precursors and chemicals frequently used
in the illicit manufacture of narcotic drugs and psychotropic
substances in Africa can be found in the report of the Board
for 2023 on the implementation of article 12 of the 1988
Convention.
144
Africa, almost 10 per cent, reportedly owing to the preva-
lence of cannabis use in Nigeria. For opioids, including pre-
scription opioids, the estimated prevalence of consumption
stood at 1.24 per cent (approximately 9.67 million people).
For opiates, mostly heroin, the estimated prevalence of con-
sumption stood at 0.50 per cent (3.9 million people). The
prevalence rates for the consumption of other drugs (i.e.,
cocaine, amphetamines and prescription stimulants and
“ecstasy”) in Africa were below 0.4 per cent of the popu-
lation in 2021. For many substances, including cannabis,
the prevalence data for some subregions of Africa were not
available. Africa is among the regions with the lowest pro-
portions of women in drug-related treatment.
475. According to UNODC, Africa, where the population
is young, is one of the regions where youth are the most
vulnerable to using drugs. The annual prevalence of the use
of cannabis in the population aged 15–16 (6.4 per cent) was
similar to the prevalence of the general population aged
15–64 (6.85 per cent). The report estimates that 70 per cent
of people in treatment in Africa are under the age of 35.
476. In 2023, the African Union launched the report of
the 2023 Pan-African Epidemiology Network on Drug
Use, which aims to improve health security and the socio-
economic well-being of people in the region by addressing
substance use and treatment.
477. The 2022 West African Epidemiology Network on
Drug Use report entitled
Statistics and Trends on Illicit Drug
Supply and Drug Abuse,
validated during an Economic
Community of West African States Commission workshop
in May 2023, identified cannabis, tramadol, amphetamines
and cocaine as the most consumed drugs in the region. It
further pointed to an increase in drug use among unem-
ployed persons aged 15–25, compared with 2021 data.
478. The National Authority for the Campaign against
Alcohol and Drug Abuse of Kenya released a report on the
2022 national survey on the status of drugs and substance
use in the country. The survey, which is conducted every
five years, was undertaken in all 47 counties and involved
3,797 households and 3,314 individuals aged 15–64 years.
Of that group, 44 per cent were 36 years old and above and
the majority (54.5 per cent) were female. The survey found
that the prevalence of cannabis use had almost doubled over
the previous five years; according to the report, that could be
attributed to the low perception of harm due to misinforma-
tion. The highest prevalence of lifetime use of cannabis was
reported in Nairobi (6.9 per cent). Alcohol was identified
as the most widely misused substance in the country, with
an estimated prevalence of 19 per cent.
6. Prevention and treatment
473. Assessing the extent of drug abuse and accurately
estimating the number of people in treatment on the African
continent remains a challenge as detailed and reliable infor-
mation and prevalence data provided from the region are
scarce.
474. However, based on the information available, can-
nabis remains the main drug of concern for the majority of
people in treatment on the African continent. According to
the UNODC
World Drug Report 2023,
the estimated annual
prevalence of cannabis consumption in Africa was 6.85 per
cent of the population (approximately 53.6 million people).
The prevalence was particularly high in West and Central
144
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479. In November 2022, the National Authority launched
a framework for community engagement in the manage-
ment of alcohol and drug abuse, the first such framework
in Kenya. The main objectives of the framework are:
(a)
to
reduce alcohol and drug use in the community;
(b)
to lever-
age joint initiatives and resources for alcohol and drug use
prevention and management; and
(c)
to standardize and
harmonize community efforts towards the reduction of
alcohol and drug use.
480. A drug use survey conducted in the framework of
the Transnational Organized Crime Threat Assessment for
Nigeria found that 14.4 per cent of Nigerian adults (aged
15–64) had used at least one illicit drug in the previous
year. In addition to the over 12.9 million cannabis users, the
findings estimated 5.6 million non-medical users of phar-
maceutical opioids and another 2.9 million non-medical
users of codeine cough syrup in the country. The widespread
non-medical use of opioids is a further major concern in
Nigeria. The results of the survey are based on responses
from 38,850 households and 9,344 high-risk drug users.
In 2022, Nigeria published
Standard Operating Procedures:
Medication-Assisted Treatment for Opioid Dependence in
Nigeria – Methadone and Buprenorphine,
in preparation
for implementing opioid-assisted therapy in the country.
481. A national school survey on substance use and
associated patterns to assess the level of tobacco, alcohol,
medicines and drug use among schoolchildren aged 15–16
in Senegal found that 9 per cent of students reported had
smoked cigarettes, 10.4 per cent had consumed alcohol in
their lifetime and 7.8 per cent had taken a tranquillizer or
painkiller. The survey also found that the use of drugs is
less frequent than the use of tobacco, alcohol or prescribed
medicines, with 3.5 per cent of young people reporting a
lifetime prevalence of psychoactive substances. The find-
ings were based on 3,303 questionnaire responses from
Senegalese students aged 15–16 in public and private sec-
ondary schools. The survey was conducted by UNODC.
482. In the course of 2023, the United Republic of Tanzania
provided treatment services to at least 854,134 persons
(434,847 men and 419,287 women) with varying drug use
disorders. The country currently runs 15 opioid substitution
therapy sites that use methadone and buprenorphine. These
clinics, located across the country, provide treatment services
to approximately 14,500 people on a daily basis, compared
with 11,500 people in 2021. The majority of people receiving
the treatment are men.
483. A third survey on the use of tobacco, alcohol and
drugs in schools, conducted in 2021 in Tunisia as part of the
Mediterranean School Survey Project on Alcohol and other
Drugs (MedSPAD), revealed an increase in the use of drugs
since the second MedSPAD survey in 2017.
484. Countries in North Africa, including Egypt, Libya
and the Sudan, have continued implementing the UNODC
Youth 4 Impact programme, which had been launched in
2022. In May 2023, UNODC launched the initiative in
Algeria. The programme aims at helping young men and
women, including those who are marginalized and at risk,
to become more empowered to face life’s challenges and to
be more resilient against crime, violence and drugs.
485. On 3 January 2023, the Transitional Sovereignty
Council in the Sudan launched the national campaign “Save
your son” to tackle drug consumption, specifically the use of
methamphetamine, which has dominated the market since
the Sudanese revolution in 2019. Alongside government
institutions, numerous non-governmental organizations
and civil society organizations have participated in the
campaign.
486. Algeria rolled out opioid agonist treatment pro-
grammes with the support of UNODC and Egypt in 2023.
In Algeria, UNODC also assisted in the development of
national guidelines for methadone agonist treatment, stand-
ard operating procedures for opioid agonist treatment and
the finalization of the National Drug and Harm Reduction
Strategy. As of June 2023, five centres are providing opioid
agonist treatment programmes, with over 300 clients
enrolled in methadone maintenance treatment.
487. In 2022, UNODC supported the development of
a monitoring and evaluation framework for the national
opioid agonist treatment programme in Egypt. The frame-
work is being used for monitoring clients enrolled in such
treatment and will also support the future evaluation of
the programme. In 2023, UNODC delivered two training
courses on the delivery of harm reduction services, particu-
larly opioid agonist treatment, in Egypt.
488. In 2022/23, UNODC conducted a first-of-its-kind
rapid situation assessment for women who use drugs in
Egypt. The assessment provided valuable insights into the
extent of substance use among women, as well as associ-
ated risk factors. The assessment offers governmental as well
as non-governmental institutions a more comprehensive
understanding of the services needed by women who use
drugs, enabling them to prioritize the appropriate services.
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INCB REPORT 2023
C. Americas
Central America and the Caribbean
Central America and the Caribbean suffers from a high level
of armed violence and insecurity, which is often linked to
the activities and violent competition of drug cartels and
street gangs.
In a number of countries in the region, the national plans on
drug control may have expired. The persistent unavailability
of recent epidemiological surveys on the prevalence of drug
use in most countries in the region may be hampering the
development of evidence-based drug control policies.
Countries in Central America and the Caribbean are increas-
ingly being targeted by traffickers attempting to smuggle
cocaine to markets in Europe.
in the CICAD Hemispheric Plan of Action on Drugs for
the period 2021–2025, including with regard to improving
access to controlled substances for medical and scientific
purposes and strengthening the exchange of information
related to drug interdiction and border control measures to
prevent drug trafficking. However, the reports also empha-
sized the need for further efforts in several areas, including
the control of synthetic drugs and new psychoactive sub-
stances. For example, more than 60 per cent of countries in
the Americas had not made progress towards establishing
and/or strengthening early warning systems, and more than
70 per cent of such countries had not developed adequate
regulatory approaches to enhance national control over the
use of new psychoactive substances and synthetic opioids
for non-medical purposes. Regarding the trafficking of
drugs in small quantities, about one half of the countries
that participated in the evaluation had only a limited range
of programmes and strategies to prevent, at the national and
international levels, the exploitation of at-risk populations
by drug trafficking networks.
492. According to the study entitled
Weapons Compass: The
Caribbean Firearms Study,
published by the Implementation
Agency for Crime and Security of the Caribbean Community
in 2023, the Caribbean region suffers from some of the
world’s highest rates of violent death, with firearms used in
the majority of homicides. The study reviewed some of the
factors that underlie gun violence in the Caribbean region,
including gang violence, drug trafficking and access to
illicit firearms. Information provided in the study regarding
trafficking in firearms and their trade for cannabis involv-
ing Haiti and Jamaica corroborates the concerns of some
regional experts regarding the links between drugs and
trafficking in firearms. In its latest annual report on global
trends, entitled “Global trends: forced displacement in 2022”,
the Office of the United Nations High Commissioner for
Refugees asserted that armed conflict, violence, human
rights violations and events seriously disturbing the public
order were among the reasons why there were more than
108 million forcibly displaced persons worldwide, including
refugees, asylum seekers and internally displaced persons, at
the end of 2022. More than 40 per cent of a total of 2.6 mil-
lion new individual asylum applications in 2022 were filed
by nationals of Latin American and Caribbean countries,
including Cuba, Haiti, Honduras and Nicaragua.
493. The UNODC report entitled “The online trafficking
of synthetic drugs and synthetic opioids in Latin America
and the Caribbean”, published in 2022, analyses diverse
aspects of the rapidly evolving phenomenon of the online
trafficking of those substances in the region. According to
the report, one estimate of the online drug trade suggested
the likelihood that in mid-2021 about 30 organized criminal
groups controlled the darknet synthetic drug markets in
1.
Major developments
489. Because of its geographical location at the crossroads
of the main coca-producing countries and the consumer
markets in North America and Europe, the region of Central
America and the Caribbean continues to be used as a tran-
sit area for the large-scale trafficking of illicit drugs. Drug
trafficking is increasingly linked to trafficking in firearms
and poses a major challenge to stability and security in the
region and the western hemisphere.
490. In November 2022, the Inter-American Drug Abuse
Control Commission (CICAD) of OAS published the
Report
on Drug Supply in the Americas 2022.
The report, covering
the period 2016–2020, provides statistical information from
30 OAS member States on the illicit supply of drugs, includ-
ing on trends in drug and laboratory seizures, illicit crop
eradication and arrests. According to the report, the primary
drug of concern varies by country, reflecting the variety of
the illicit supply of drugs across the region. Cannabis stands
out as the only drug in relation to which illicit supply was
mentioned by all OAS member States that provided data
for the report.
491. In December 2022, CICAD released the thematic
national evaluation reports of the Multilateral Evaluation
Mechanism for 2022, on measures to control and counter
the illicit cultivation, production, trafficking and distri-
bution of drugs and to address their causes and conse-
quences. The reports indicated that, among the countries
evaluated, there was a high level of compliance with the
priority actions relating to drug supply reduction outlined
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
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Latin America and the Caribbean. The report concluded
that further monitoring of the Internet and additional
surveys on the online marketing of drugs are required to
better estimate the magnitude of the illicit online market
for synthetic drugs and synthetic opioids. The report also
advocated for enhanced cooperation between anti-drug
agencies and specialized cybercrime units to investigate
this increasingly complex issue.
psychoactive substances, synthetic opioids and other dan-
gerous substances. The event was also aimed at strengthen-
ing information exchange using the IONICS and GRIDS
Intelligence HD targeting tools. The event included field
visits to the customs facilities at the international airport in
Santo Domingo and a forensic laboratory.
497. In December 2022, the GRIDS Programme con-
ducted a capacity-building training event in Guatemala
for officials from law enforcement and regulatory agen-
cies on the safe interdiction of synthetic opioids, fentanyl-
related substances and new psychoactive substances and
on strengthening intelligence exchange using IONICS and
GRIDS Intelligence HD. The event also included field visits
to a forensic laboratory and the headquarters of the anti-
narcotics police.
498. In August 2023, the GRIDS Programme conducted
a capacity-building training event in Trinidad and Tobago
for officers from the Regional Intelligence Fusion Centre of
the Caribbean Community’s Implementation Agency for
Crime and Security on the safe interdiction of synthetic
opioids, fentanyl-related substances and new psychoactive
substances and on strengthening intelligence exchange
using IONICS and GRIDS Intelligence HD. The event also
included a field visit to the Trinidad and Tobago Forensic
Science Centre. In the same month, the GRIDS Programme
conducted a similar training event in Barbados for offic-
ers of the Joint Regional Communications Centre of the
Caribbean Community’s Implementation Agency for Crime
and Security.
499. The sixth annual operational meeting on counter-
ing trafficking of dangerous synthetic drugs and chemicals
through postal, courier and air cargo services, held by the
GRIDS Programme in Vienna in September 2023, brought
together participants from 31 Governments and five inter-
national organizations. Several participating Governments
also engaged in bilateral or multilateral case meetings facili-
tated by INCB that were held on the margins of the meeting.
In addition, the GRIDS Programme, in collaboration with
the WCO Regional Intelligence Liaison Office for Central
America, hosted its first “twinning” programme, in the form
of an event to provide opportunities for trust-building,
active networking and training on real-time trafficking inci-
dents. The event was held in Central America in October
2023 and included the participation of law and regulatory
enforcement officers from El Salvador, Guatemala and
Panama. The officers developed practical skills for inter-
national operational cooperation, cross-border communi-
cation, and awareness-raising related to synthetic opioids.
500. UNODC continued to cooperate closely with inter-
governmental organizations in the region, including the
2.
Regional cooperation
494. CICAD, INCB and UNODC continued to organize
expert meetings and provide training for the competent
national authorities of the countries of Central America and
the Caribbean. Drug control officials from 16 countries in
Central America and the Caribbean have registered to use
INCB Learning e-modules. An INCB Learning regional
training seminar and an awareness-raising availability
workshop, for officials from competent national authori-
ties of Costa Rica, the Dominican Republic, El Salvador,
Guatemala, Honduras and Panama, were held in February
2023 in San Salvador. The officials participated in the two
training events, dedicated to the implementation of provi-
sions of the international drug control treaties. The one-day
awareness-raising availability workshop brought together
specialists from Governments, PAHO/WHO and civil
society to find ways to improve access to narcotic drugs
and psychotropic substances for medical use in the region.
Both activities were organized in close collaboration with
the Government of El Salvador and CICAD.
495. In Central America and the Caribbean, Container
Control Programme units and AIRCOP task forces under
the UNODC Passenger and Cargo Border Team are now
operational in the Bahamas, Barbados, Costa Rica, Cuba,
the Dominican Republic, El Salvador, Guatemala, Haiti,
Honduras, Jamaica, Panama and Trinidad and Tobago. The
Dominican Republic, El Salvador and Panama participated
in Operation Insight, a global operation launched in 2023 by
INCB in cooperation with the Passenger and Cargo Border
Team. The operation was designed to suppress the illicit
trafficking of precursors of drugs and explosives through
free trade zones and to raise the awareness of national con-
trol authorities regarding the vulnerability of such zones (see
the report of the Board for 2023 on the implementation of
article 12 of the 1988 Convention).
145
496. In November 2022, the INCB GRIDS Programme
held a training event in the Dominican Republic for law
enforcement and regulatory officers focused on awareness-
raising and safe handling practices related to new
145
E/INCB/2023/4.
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INCB REPORT 2023
Caribbean Community, its Implementation Agency for
Crime and Security, and the Central American Integration
System. For example, officials from Guatemala and
Honduras participated in several activities conducted in the
framework of the UNODC programme entitled “Safe han-
dling and disposal of seized drugs and precursor chemicals”.
Officials from Costa Rica and Panama were among those
participating in a regional training event on the investiga-
tion of cryptocurrency-enabled crime, organized in Panama
in June 2023 within the framework of the UNODC Global
Programme on Cybercrime. In addition, the UNODC global
Synthetics Monitoring: Analyses, Reporting and Trends
(SMART) programme continued to strengthen the capa-
bilities of forensic laboratories in the detection and analysis
of synthetic drugs and new psychoactive substances in Latin
America and the Caribbean, including in the Dominican
Republic, El Salvador, Guatemala and Honduras.
501. Over the course of 2022, the Inter-American
Observatory on Drugs of CICAD continued to provide tech-
nical assistance to OAS member States and their national
drug observatories through online and in-person training
events, including webinars, training courses and round
tables on a variety of topics related to research methods,
drug information networks and early warning systems. The
Early Warning System for the Americas (SATA) continued
to collect, analyse and disseminate alerts on emerging drug
threats issued by El Salvador and Trinidad and Tobago, as
well as Argentina, Brazil, Chile, Colombia and Uruguay.
502. Building on earlier progress, the Cooperation
Programme between Latin America, the Caribbean and
the European Union on Drugs Policies, in its third phase
(COPOLAD III), continued to promote technical coopera-
tion and political dialogue between the European Union
and countries in the Latin American and Caribbean
region in support of the implementation of more effec-
tive drug policies in the region. Countries participating
in the programme included Antigua and Barbuda, the
Bahamas, Barbados, Belize, Costa Rica, Cuba, Dominica,
the Dominican Republic, El Salvador, Grenada, Guatemala,
Haiti, Honduras, Jamaica, Nicaragua, Panama, Saint Kitts
and Nevis, Saint Lucia, Saint Vincent and the Grenadines,
and Trinidad and Tobago. In 2022 and 2023, the programme
supported a wide range of activities, including training for
national drug observatories on early warning systems, the
exchange of experiences on care practices for people with
drug-related problems, in particular women and vulnerable
populations, the exchange of best practices regarding the use
of special drug-related investigative techniques and expert
meetings on the chemical concealment of cocaine.
503. A joint operation targeting firearms trafficking,
Operation Trigger VII, conducted in September 2022 by
19 countries, including Antigua and Barbuda, the Bahamas,
Barbados, Belize, Dominica, the Dominican Republic,
Grenada, Haiti, Jamaica, Saint Kitts and Nevis, Saint Lucia,
Saint Vincent and the Grenadines, and Trinidad and Tobago,
and supported by INTERPOL and the Implementation
Agency for Crime and Security of the Caribbean
Community, led to seizures of more than 300 weapons,
ammunition and 12.6 tons of drugs, thus highlighting the
convergence of trafficking routes and the use of firearms
to control the illicit drug trade in the Caribbean. Several
countries reported the trafficking of illicitly produced can-
nabis from Canada and the United States of America into
the Caribbean subregion.
504. In May 2023, Antigua and Barbuda, the Dominican
Republic, Grenada and Jamaica participated in Operation
Caribe, a pilot operation of the fifth phase of the Seaport
Cooperation Project (SEACOP V). SEACOP V is aimed at
combating maritime trafficking and criminal networks in
the Caribbean, Latin America and West Africa. The opera-
tion, which lasted for two weeks, was focused on leisure
and commercial craft, and resulted in, inter alia, seizures of
a total of more than 1.1 tons of cocaine in the Dominican
Republic.
3.
Availability of internationally
controlled substances, including
reporting to the Board
505. The three international drug control treaties require
States parties to furnish statistical reports to the Board on an
annual basis. The reports enable the Board to monitor licit
activities involving internationally controlled substances
and ensure the availability of those substances for medical
and scientific purposes.
506. The consumption of opioid analgesics for medical
and scientific purposes, expressed in S-DDD per million
inhabitants, has gradually increased in Central America
and the Caribbean, with some fluctuations over the last
20 years, reaching a regional total of 10,631 S-DDD
pm
in
2021, triple the level in 2002. Fentanyl accounted for most of
the consumption of opioid analgesics in the region in 2021
(7,053 S-DDD
pm
), followed by morphine (1,680 S-DDD
pm
),
oxycodone (1,211 S-DDD
pm
), pethidine (616 S-DDD
pm
)
and hydrocodone (70 S-DDD
pm
). Consumption of opioid
analgesics above 300 S-DDD
pm
was, for example, reported
by the Bahamas, Barbados, Costa Rica, El Salvador, Panama
and Saint Vincent and the Grenadines. The Board con-
siders levels of consumption of opioid analgesics below
200 S-DDD
pm
to be inadequate.
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507. Of the countries and territories of Central America
and the Caribbean, approximately three quarters have
regularly provided their annual statistical report on psy-
chotropic substances, as required by the 1971 Convention.
Of the remaining countries and territories in the region,
nearly all have failed to provide any statistical reports in
the past five years, which hampers efforts to determine the
availability of psychotropic substances in the region. It also
remains challenging to determine the levels of consump-
tion of psychotropic substances in Central America and the
Caribbean, as only a third of the countries and territories
in the region have provided consumption data on any psy-
chotropic substance to the Board for the past five years. The
Board emphasizes the importance of ensuring the sufficient
availability of and access to internationally controlled sub-
stances for medical purposes in all countries worldwide,
including in Central America and the Caribbean.
508. With regard to precursor chemicals, in the con-
text of Commission on Narcotic Drugs resolution 49/3,
Member States voluntarily provide estimates of their annual
legitimate requirements for imports of certain precursor
chemicals frequently used in the illicit manufacture of
amphetamine-type stimulants. Among other substances, the
provision of annual legitimate requirements is requested for
ephedrine and pseudoephedrine, substances that also have
medicinal uses, as well as, to the extent possible, for prepara-
tions containing those substances that could be easily used
or recovered by readily applicable means.
509. Out of the 20 countries in the region, 17 (85 per cent)
had provided the Board with at least one estimate of their
annual legitimate requirements for imports of ephedrine,
pseudoephedrine or their preparations. Of the countries that
provided those estimates, five prohibited imports of ephe-
drine or pseudoephedrine (as a raw material or in the form
of pharmaceutical preparations) into their respective ter-
ritories. Two countries have not updated their estimates of
annual legitimate requirements for ephedrines in all forms
in the past 10 years, which undermines the potential of those
data as a tool to inform exporting countries of the legitimate
requirements of importing countries for those substances.
Updating the estimates of annual legitimate requirements
assists Governments in preventing oversupply and diver-
sion into illicit channels and ensuring their availability for
legitimate purposes. In the last five years, three countries in
Central America and the Caribbean, namely, the Bahamas,
Grenada and Trinidad and Tobago have provided estimates
of annual legitimate requirements for ephedrines for the
first time.
510. Further information on the availability of interna-
tionally controlled substances can be found in the technical
reports of the Board for 2023 on narcotic drugs,
146
psycho-
tropic substances
147
and the implementation of article 12
of the 1988 Convention.
148
In addition, the publication
entitled
Guide on Estimating Requirements for Substances
under International Control,
developed by INCB and WHO
for use by competent national authorities, and the docu-
ment entitled “Issues that Governments may consider when
determining annual legitimate requirements for imports
of ephedrine and pseudoephedrine” are available on the
Board’s website.
4. National legislation, policy and
action
511. Antigua and Barbuda is drafting a new drug strategy,
covering the period 2024–2028, which will replace the cur-
rent national anti-drug strategy, covering the period 2019–
2023. The Ministry of Justice of Cuba, in accordance with its
resolution 635 of November 2022, updated the institutional
plans on drug control that serve as the methodological bases
for the development of the national programmes of each
competent national authority. According to the information
available, national drug policies and/or national plans on
drug control in a number of countries in the region have
expired.
512. In March 2022, the Government of El Salvador
declared a state of emergency to address the deteriorating
security situation in the country. Amendments were made
to legislation in July 2023 which increased the duration of
imprisonment for those found to be street gang leaders and
permitted group trials of a larger number of people if they
are accused of being in the same criminal group.
513. According to a report prepared by the National Anti-
Drug Commission of El Salvador on the security and drug
trafficking situation in the country, young people between
15 and 29 years of age have accounted for the highest inci-
dence of arrests for drug-related crimes in recent years. In
2020, of the young people between 15 and 24 years of age
in the country, about 340,000 (26 per cent) were neither
students nor employed. Those young people, mainly from
low-income backgrounds, became easy targets for organ-
ized criminal groups seeking to recruit them for criminal
activities.
514. Haiti acts as a transit country for trafficking in illicit
drugs, primarily cocaine and cannabis, which are mostly
shipped onwards to the Dominican Republic, the United
146
147
148
E/INCB/2023/2.
E/INCB/2023/3.
E/INCB/2023/4.
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INCB REPORT 2023
States and Western Europe. In 2023, gang violence in the
Haitian capital, Port-au-Prince, expanded at an alarming
rate in areas of the city that had previously been considered
relatively safe. Heavily armed criminal gangs targeted criti-
cal infrastructure, including ports and police stations, and
gained control of major highways to the capital. According
to government officials, 80 per cent of the cities in the
country were under the control or influence of armed
groups. Compared with the first quarter of 2022, criminal
incidents, including homicides, rapes, kidnappings and
lynchings, more than doubled in the corresponding period
in 2023.
515. UNODC, in its assessment entitled “Haiti’s criminal
markets: mapping trends in firearms and drug trafficking”,
expressed concerns regarding the increased trafficking
of sophisticated, high-calibre firearms and ammunition
into Haiti by land, air and, most frequently, sea. Pursuant
to Security Council resolution 2645 (2022), in which the
Council requested the United Nations Integrated Office in
Haiti to work with UNODC to support Haitian authori-
ties in combating illicit financial flows, as well as traffick-
ing and diversion of arms and related material, and in
enhancing management and control of borders and ports,
the Government of Haiti and UNODC agreed to improve
cooperation between all relevant institutions, with a view
to strengthening the national capacity to combat illicit traf-
ficking, organized crime and terrorism and to increasing
revenue collection.
516. The law enforcement authorities in Jamaica have
expressed concern about the influence of the illicit pro-
duction of cannabis on the environment, including in rela-
tion to the demand for water and pollution. While legally
licensed cannabis production in the country must comply
with environmental protection standards, illicit cannabis
production continues to be a problem because of its impact
on land and the availability of water for legitimate agricul-
tural production in the country.
517. In 2023, the competent national authorities of
Panama initiated the implementation of national legisla-
tion regulating the production of cannabis and its use for
medical purposes in the country.
518. According to the annual report of the UNODC-
WCO Container Control Programme for 2022, published
in January 2023, seven new port control units were recently
established worldwide, including one in Santiago, Cuba, and
three in the Dominican Republic, in Manzanillo and Puerto
Plata and at the border with Haiti.
519. In 2022, Trinidad and Tobago and UNODC signed
a memorandum of understanding on the country’s
participation in the Airport Communication Programme
(AIRCOP), which is a multi-agency programme imple-
mented by UNODC in partnership with INTERPOL and
WCO in more than 40 airports in Africa, Latin America
and the Caribbean, the Middle East, South-East Asia and
South-Eastern Europe. AIRCOP is aimed at strengthening
the capacities of international airports to target and inter-
cept high-risk passengers, cargo and mail, as a contribution
to, inter alia, the fight against illicit drugs and trafficking
in persons. Since 2010, AIRCOP task forces have seized a
combined total of more than 20 tons of illicit drugs, new
psychoactive substances and khat, in addition to precursors,
counterfeit medicines, weapons and currency.
5.
Cultivation, production,
manufacture and trafficking
520. According to the CICAD
Report on Drug Supply
in the Americas 2022,
the total amount of cocaine seized
in the western hemisphere rose from about 911 tons in
2016 to 1,091 tons in 2020. While, in Central America,
the amount of cocaine seized steadily rose from 51 tons
in 2016 to more than 71 tons in 2020, in the Caribbean,
the amount seized decreased from 13 tons to 9 tons over
the same period. The record level of illicit manufacture of
cocaine in South America, which in 2021 reached a high
of 2,304 tons of pure substance, has resulted in a further
increase in cocaine trafficking affecting the Americas as a
whole. According to UNODC, in 2022, customs and other
law enforcement agencies participating in the efforts of
AIRCOP and the Container Control Programme under the
UNODC Passenger and Cargo Border Team seized more
than 275 tons of cocaine, over 100 tons more than in the
previous year.
521. Cocaine manufactured illicitly in Colombia is usually
trafficked to North America either directly from ports on the
Pacific or Caribbean coasts or through Brazil and Venezuela
(Bolivarian Republic of) northward towards the Caribbean
and Central America.
522. According to the European Monitoring Centre for
Drugs and Drug Addiction, most of the cocaine seized in
the European Union or in transit to Europe is concealed in
cargo ships and shipped directly from the main cocaine-
manufacturing countries, in particular Colombia; neigh-
bouring countries in South America, in particular Brazil
and Ecuador; or countries in Central America and the
Caribbean. A route that runs through the Caribbean, involv-
ing other forms of sea transport, as well as air transport,
also runs through North and West Africa, including the
islands off the coast of West Africa. Cocaine hydrochloride
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trafficked to Europe is often concealed in carrier materi-
als and later extracted in Europe in dedicated extraction
facilities.
523. In Costa Rica, the amount of cocaine seized decreased
from 44.3 tons in 2021 to 24.8 tons in 2022, a decrease of
44 per cent. In the Dominican Republic, 31.1 tons of diverse
illicit drugs were seized in 2022, about 5 tons more than
the 25.9 tons seized in 2021. The seizures in 2022 included
27.7 tons of cocaine and 3.3 tons of cannabis herb. A fur-
ther 2.8 tons of cocaine were seized the country in the first
trimester of 2023. In Guatemala, 1.6 tons of cocaine were
seized and 3.7 million coca plants were eradicated in 2022.
In recent years, Guatemala and Honduras have reported the
discovery of small coca plantations and a limited number of
illicit cocaine laboratories.
524. In 2022, according to media reports, El Salvador reg-
istered the second largest cocaine seizure (12 tons) in the
last 34 years, reportedly due to the Government’s efforts to
curtail gangs operating in the country. Moreover, in mid-
July 2023, the Government stated that it had reached more
than 290 days without a homicide in the country since the
state of emergency was introduced.
525. In Panama, a total of 138.4 tons of drugs were seized
in 2022, most of which was cocaine (108.8 tons), followed
by cannabis herb (29.5 tons), representing a decrease of
6.8 tons in comparison with the amount of drugs seized in
the country in 2021. In January 2023, a further 5.6 tons of
cocaine and 2.3 tons of cannabis were seized in Panama. In
Trinidad and Tobago, the amount of cocaine seized ranged
from 130 kg to 380 kg per year in the period 2018–2021,
with a decline being observed in 2022, when only 17 kg of
the substance were seized.
526. According to the CICAD
Report on Drug Supply in
the Americas 2022,
increased cannabis cultivation and traf-
ficking was reported by eight countries in the Caribbean
in the period 2016–2020. Overall, from 2016 to 2020, the
amount of cannabis seized in Central America and the
Caribbean slightly increased. There were reports of inno-
vations in cannabis trafficking in Central America, such
as trafficking in liquid cannabis or cannabis suspended in
wax. In Jamaica, the authorities noted a high international
demand for cannabis cultivated illicitly in that country, due
to its perceived superior quality.
527. In 2022, Costa Rica reported the largest total
amount of cannabis herb seized in the country (25.1 tons)
since 2000. In addition, more than 600,000 cannabis plants
were eradicated and 13.5 tons of cannabis herb were seized
in the country in the first half of 2023. Two tons of canna-
bis herb were seized and 5.3 million cannabis plants were
eradicated in Guatemala in 2022. In Honduras, cannabis
seizures have been reported in all regions of the country
in recent years.
528. While cannabis is locally produced in Trinidad and
Tobago, the substance is also trafficked into the country
from Guyana, Jamaica, Saint Vincent and the Grenadines
and Venezuela (Bolivarian Republic of). In 2022, 580 kg of
cannabis were seized in Trinidad and Tobago, a decrease
from what was reported in the period 2018–2021, when,
on average, 2,950 kg of cannabis were seized annually in
the country. In the same year, 6,900 fully grown cannabis
plants were eradicated, a decrease from what was reported in
the period 2019–2021, when, on average, 163,000 cannabis
plants were eradicated annually in the country.
529. Across Central America and the Caribbean, the
number of arrests involving cannabis did not surpass
10,000 per year in each subregion in the period 2016–2020.
According to CICAD, the relatively low number of arrests
may have been due in part to the decriminalization of the
possession of small amounts of cannabis, especially in the
Caribbean, as well as the overall low number of countries in
the Americas that provided such information (15 countries).
530. In Trinidad and Tobago, in the period 2020–2022,
there was an average of 470 arrests per year for the posses-
sion of cannabis, which was a significant decrease from the
previous period of 2018–2019, in which there was an aver-
age of 3,200 arrests per year. That decrease could in part be
attributed to the amendment of the country’s Dangerous
Drugs Act in December 2019, which decriminalized the
cultivation and possession of small quantities of cannabis.
531. Illicit opium cultivation and heroin manufacture and
trafficking do not appear to be of concern for the coun-
tries in the region, except for Guatemala, which reported
the eradication of almost 10 million opium poppy plants in
2022, and the Dominican Republic, which has reported a
low-level prevalence of heroin use in recent years.
532. In August 2023, according to an open source of infor-
mation, the competent national authorities of Trinidad and
Tobago dismantled the first methamphetamine laboratory
in the country. Since 2017, seizures of amphetamine and
methamphetamine have been reported by several coun-
tries in the region, including the Bahamas, Barbados,
Belize, the Dominican Republic, El Salvador, Guatemala,
Panama and Trinidad and Tobago. Seizures of “ecstasy” have
been reported by the Bahamas, Costa Rica, the Dominican
Republic, El Salvador, Guatemala, Panama and Trinidad
and Tobago. Seizures of LSD have been reported by Costa
Rica and Honduras. Costa Rica, Panama and Trinidad and
Tobago have reported seizures of ketamine in recent years.
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INCB REPORT 2023
6. Prevention and treatment
533. The Board has noted with concern the continued
lack of recent epidemiological surveys on the prevalence
of drug misuse in most countries in Central America and
the Caribbean. In many countries of the region, the latest
estimates of the annual prevalence of use of illicit drugs
among the general population are more than 10 years old.
For example, within the region, the most recent estimates
of the prevalence of use of cannabis, cocaine and ampheta-
mines among the general population aged 15–64 were made
in 2018, in Haiti, and the most recent estimates of the preva-
lence of use of “ecstasy”-type substances and prescription
stimulants among the general population were made in
2015, in Costa Rica and Panama. There are no recent esti-
mates available to enable the production of estimates of the
extent of opioid use in the region.
The Board reiterates its
call to the countries concerned to prioritize the collec-
tion of data on drug use trends and treatment demand
in order to inform the development of evidence-based
drug control policy and encourages bilateral partners
and regional and international organizations to provide
support to this end.
534. As estimated by UNODC in 2021, the past-year
prevalence of cannabis use among the adult population
was 3.1 per cent in Central America and 5.7 per cent in
the Caribbean. In Jamaica, in 2016, the most recent year
for which data are available, the past-year prevalence of
cannabis use among the adult population was 18 per cent,
which was, for purposes of comparison, higher than the
global average of 4.3 per cent for 2021. According to the
National Anti-Drug Commission of El Salvador, the most
common combinations of substances for which patients in
the country received treatment for polydrug use in 2022
were, in order of prevalence, cannabis herb with cocaine
hydrochloride, cannabis herb with benzodiazepines and
cannabis herb with “crack” cocaine or freebase cocaine.
535. According to the
World Drug Report 2023,
the
annual prevalence of the use of cocaine among persons
aged 15–64 years in Central America and in the Caribbean,
as estimated in 2021, was 0.96 per cent and 0.19 per cent,
respectively, and considerably lower than that in North
America (1.88 per cent) and South America (1.62 per cent).
According to the same source, the annual prevalence of the
use of amphetamines and prescription stimulants among
adults in Central America was 0.99 per cent, and that of
“ecstasy” was 0.17 per cent. The annual prevalence of the
use of those substances in the Caribbean was not provided.
With regard to new psychoactive substances, Costa Rica and
El Salvador reported the use of ketamine, mephedrone and
synthetic cannabinoids among the general population aged
15–64 years in their territories in the period 2015–2018.
536. The percentage of people under 25 years of age
in treatment for drug use in Central America and the
Caribbean (37 per cent) is, according to UNODC, the
second highest among all regions worldwide, after South
America (52 per cent).
537. According to the best estimates from the latest
UNODC/WHO/UNAIDS/World Bank data, published
in 2023, among the population aged 15–64, about 20,000
people in Central America and about 100,000 people in
the Caribbean inject drugs. The best estimate of the global
prevalence of HIV among injecting drug users was 11.9 per
cent. In Central America and in the Caribbean, where HIV
prevalence data were available for one third of all people
who inject drugs, this prevalence was estimated at 0.95 per
cent and 10.8 per cent, respectively. Data from PAHO
indicate that, while the number of new HIV cases in Latin
America is estimated to have increased by 4.7 per cent from
2010 to 2021, with approximately 110,000 new cases in 2021,
the number of new cases in the Caribbean decreased by
28 per cent over the same period, from an estimated 19,000
per year to 14,000 per year. It is estimated that 18 per cent
of people with HIV in Latin America and in the Caribbean
are unaware of their condition.
North America
The opioid crisis continued to have serious consequences
in the countries of the region. An increasing number of
opioid toxicity deaths over the period under consideration
involved illicitly manufactured fentanyl, often mixed with
other synthetic drugs, including stimulants or benzodiaz-
epine analogues.
The united States launched the Global Coalition to Address
Synthetic Drug Threats, which is aimed at preventing the
illicit manufacture and trafficking of synthetic drugs, detect-
ing emerging drug trends, and drug use patterns, and
responding to public health impacts, in partnership with
Governments, as well as the private sector, civil society,
hospitals and public health stakeholders.
Illicit drug-related activity by cartels and criminal gangs in
mexico continues to result in high levels of violence, in par-
ticular homicides, in the country.
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1.
Major developments
2.
Regional cooperation
538. The opioid crisis resulting from an increasingly adul-
terated illicit drug supply continued to have serious conse-
quences in North America. Drug overdose deaths in the
United States have risen fivefold over the past two decades,
with over 106,000 such deaths in 2021 alone. In Canada,
there were more than 36,000 apparent opioid toxicity deaths
between 2016 and 2022. An increasing number of opioid
toxicity deaths over the period under consideration involved
illicitly manufactured fentanyl, often mixed with other syn-
thetic drugs, including stimulants or benzodiazepine ana-
logues, reflecting the polysubstance nature of the crisis.
539. In response, all three countries of the region have
strengthened their legislation related to precursor chemi-
cals. In particular, Canada permanently scheduled a group
of novel fentanyl precursors, which are analogues and deriv-
atives of
N-phenyl-4-piperidinamine
(4-AP) and its salts,
under the Controlled Drugs and Substances Act. This meas-
ure came into effect on 30 August 2023 and is intended to
enable law enforcement authorities to continue acting against
any illegal importation, distribution and use of those pre-
cursor chemicals. Derivatives or analogues of fentanyl pre-
cursors are also being placed under national control in the
United States, including certain derivatives of 4-piperidone
and halide analogues of 4-AP, effective 30 November 2023.
540. The President of the United States extended the
national emergency with respect to global illicit drug
trafficking, which had first been initiated by an executive
order issued on 15 December 2021, beyond 15 December
2022. Under the order, international drug trafficking,
including the illicit production, global sale and widespread
distribution of illegal drugs, the rise in high-potency drugs
such as fentanyl and other synthetic opioids and the growing
role of Internet-based drug sales are considered to continue
posing an unusual and extraordinary threat to the national
security, foreign policy and economy of the country.
541. During a ministerial-level meeting, which was held
virtually on 7 July 2023, the United States Secretary of State
launched the Global Coalition to Address Synthetic Drug
Threats. The Coalition, formalized through a joint ministerial
declaration signed by 81 Governments, is aimed at prevent-
ing the illicit production and trafficking of synthetic drugs,
detecting emerging drug trends, and drug use patterns, and
responding to public health impacts, in partnership with civil
society, hospitals and public health stakeholders, as well as
the private sector, including chemical manufacturers, ship-
ping companies and social media platforms. The Coalition
is expected to reconvene at the political level on the margins
of various high-level political events.
542. Effective cooperation in law enforcement matters
and in combating illicit drug manufacture and trafficking
continued to be promoted through various regional mecha-
nisms. At the 2023 North American Leaders’ Summit, held
on 9 and 10 January 2023, Canada, Mexico and the United
States committed to coordinating actions and strategies to
combat arms and drug trafficking that represent a shared
threat to the three countries. The countries also agreed to
continue their collaboration within the North American
Drug Dialogue under an updated strategic framework to
address illegal drug threats and strengthen public health
approaches to substance use. That included increased dis-
tribution of overdose reversal medications and information-
sharing on chemicals used in the illicit manufacture of
fentanyl and other synthetic drugs.
543. Mexico and the United States continued to cooper-
ate within the Bicentennial Framework for Security, Public
Health and Safe Communities. On 9 March 2023, a second
phase of the framework was launched, and the two countries
agreed to further increase cooperation to combat the illicit
manufacture and use of fentanyl, as well as arms trafficking,
across the region. On that occasion, approximately $25 mil-
lion in funds stolen by criminal actors through embezzle-
ment and fraud that were seized and forfeited by the United
States Department of Justice were returned to the federal
Government of Mexico. The funds were earmarked to be
used to advance the goals of the Bicentennial Framework.
On 13 April 2023, further collaboration was announced
within the Framework, including public awareness cam-
paigns and commitment to continued cooperation to dis-
mantle the fentanyl supply chain on both sides of the border
between the two countries.
544. On the same day, the first meeting of the senior-
level Trilateral Fentanyl Committee was convened. The
Committee, comprising senior-level officials from Canada,
Mexico and the United States, recognized synthetic opioids,
in particular fentanyl, as the foremost drug threat in North
America, and the three countries agreed to work together
to disrupt the global transfer, facilitation and supply of illicit
fentanyl and the precursor chemicals and equipment used in
its illicit manufacture before they reach North America. The
Committee also pledged to coordinate international actions
to mobilize other countries impacted by synthetic drugs,
such as methamphetamine, “captagon” and tramadol. The
formation of the Committee was agreed during the North
American Leaders’ Summit in January 2023.
545. INCB has been supporting countries of the region in
addressing the emergence of highly potent synthetic drugs
through the activities of its Global Rapid Interdiction of
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INCB REPORT 2023
Dangerous Substances (GRIDS) Programme, including
through the use of tools such as IONICS, which facilitates
the exchange of real-time information between national
authorities. As of July 2023, over 2,200 incidents had been
communicated concerning interdictions and seizures of opi-
oids through the platform by law enforcement focal points
for North America. On 9 December 2022, the INCB GRIDS
Programme provided in-person support for 33 law enforce-
ment and regulatory officers from the Technical Group for
Synthetic Drug Control of Mexico, focused on strengthen-
ing information exchange using the IONICS and GRIDS
Intelligence targeting tools.
546. Between December 2022 and January 2023, Mexico
and the United States participated in the INCB Operation
Knockout and exchanged intelligence to identify and disman-
tle illicit manufacturing and distribution points involving
non-medical 1,4-butanediol, carisoprodol, flubromazepam,
gamma-butyrolactone
and ketamine trafficked through
international postal, express mail and courier services and
related modalities.
547. From 21 to 23 February 2023, the INCB GRIDS
Programme organized an online stakeholder consulta-
tion on voluntary cooperation between Governments and
freight forwarding services for the prevention of trafficking
in dangerous substances. The event was attended by more
than 44 representatives from 10 Governments, three inter-
national organizations and six industry associations, includ-
ing 13 participants from Canada, Mexico and the United
States. Participants exchanged best practices and shared case
examples related to the exploitation of legitimate ancillary
logistics services and discussed the next steps for promot-
ing voluntary cooperation between Governments and their
private sector partners.
548. The GRIDS Programme convened, in Mexico City
in June 2023, the second regional expert group meet-
ing on the exploitation of Latin American and Caribbean
e-commerce platforms for the marketing and sale of dan-
gerous substances. The meeting was aimed at engaging
stakeholders in discussions regarding the current trends in
regional trafficking in synthetic drugs, fentanyls and related
chemicals, challenges confronting e-commerce platforms
and promising practices to prevent future exploitation by
traffickers. More than 29 stakeholders, including repre-
sentatives from the Governments of Mexico and the United
States, international organizations, regional industry asso-
ciations and leading private sector companies, participated
in the event.
549. In Vienna in September 2023, the GRIDS Programme
organized the sixth annual operational meeting on counter-
ing trafficking of dangerous synthetic drugs and chemicals
through postal, courier and air cargo services. The event
brought together over 100 participants from 30 Governments
and international organizations, including participants from
Canada, Mexico and the United States. Several participating
Governments also engaged in bilateral and multilateral case
meetings to enhance cooperation across borders, facilitated
by INCB.
550. Also in Vienna in September 2023, the GRIDS pro-
gramme convened the third international expert group
meeting on expanding the INCB lists of dangerous sub-
stances with no known legitimate uses and novel approaches
for their identification in falsified or illicitly manufactured
pharmaceuticals. The event brought together nearly 45 par-
ticipants from 20 Governments and international organi-
zations, including participants from Canada, Mexico and
the United States.
551. A total of 228 drug control officials from the com-
petent national authorities of the three countries in North
America have registered to use INCB Learning e-modules.
The existing e-modules cover the topics of narcotic drugs,
psychotropic substances, precursors, the international drug
control framework and ensuring the adequate availability of
controlled substances for medical and scientific purposes.
3.
Availability of internationally
controlled substances, including
reporting to the Board
552. The Board acknowledges the timely and thorough
reporting of data by the competent national authorities of
all three countries of the region, as required by the inter-
national drug control conventions and requested in the rele-
vant resolutions of the Economic and Social Council and
the Commission on Narcotic Drugs, including the voluntary
reporting of data on the domestic consumption of psycho-
tropic substances.
553. According to the reported data, Canada and the
United States have maintained a high level of availabil-
ity of opioid analgesics, peaking in 2014 with a total of
75,408 S-DDD
pm
for the two countries. However, availability
has been steadily decreasing, falling to the levels of 20 years
ago, at 48,867 S-DDD
pm
in 2021. In 2021, the United States
reported the consumption of 31,860 S-DDD
pm
in 2021, with
Canada reporting the consumption of 17,007 S-DDD
pm
the same year. With regard to Mexico, the availability of
opioid analgesics in the country has been much lower,
as consumption has never exceeded 200 S-DDD
pm
, the
threshold considered adequate by the Board, between 2013
and 2020. In 2021, Mexico exceeded the Board’s threshold of
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adequacy for the first time as it reported the consumption of
277 S-DDD
pm
. Among all countries in North America, the
most consumed opioid in 2021 was hydrocodone (mostly
consumed in the United States), followed by oxycodone,
fentanyl, hydromorphone and morphine.
554. Psychotropic substances, used for the treatment
of a wide range of mental health and neurological disor-
ders, have been manufactured and traded throughout the
region for decades. The consumption of those substances as
reported by Governments indicates that they are generally
available for legitimate medical purposes.
555.
The Board highlights the importance of ensur-
ing that narcotic drugs and psychotropic substances
are available for legitimate purposes, while putting
in place adequate policies and practices to prevent
their overprescription and misuse. The Board reminds
Governments of the need to foster responsible prescrip-
tion practices and controls on distribution to avoid diver-
sion into illicit channels and overconsumption resulting
in dependence and associated harms.
556. With regard to precursor chemicals, in the con-
text of Commission on Narcotic Drugs resolution 49/3,
Member States voluntarily provide estimates of their annual
legitimate requirements for imports of certain precursor
chemicals frequently used in the illicit manufacture of
amphetamine-type stimulants. Among other substances, the
provision of annual legitimate requirements is requested for
ephedrine and pseudoephedrine, substances that also have
medicinal uses, as well as, to the extent possible, for prepara-
tions containing those substances that could be easily used
or recovered by readily applicable means. As at 1 November
2023, all three countries in the region had provided at least
one estimate of their annual legitimate requirements for
imports of ephedrine, pseudoephedrine or their prepara-
tions, and all three have regularly updated their estimates
for those substances, which contributes to preventing their
oversupply and diversion into illicit channels and ensuring
their availability for legitimate purposes.
557. Further information and analysis of trends relating
to the availability of internationally controlled substances
are contained in the technical reports of the Board for
2023 on narcotic drugs,
149
psychotropic substances
150
and
the implementation of article 12 of the 1988 Convention.
151
In addition, the publication entitled
Guide on Estimating
Requirements for Substances under International Control,
developed by INCB and WHO for use by competent
149
150
151
national authorities, and the document entitled “Issues
that Governments may consider when determining annual
legitimate requirements for imports of ephedrine and pseu-
doephedrine” are available on the Board’s website.
4. National legislation, policy and
action
558. In support of the implementation of the National
Drug Control Strategy and to address the illicit fentanyl
supply chain, in April 2023, the President of the United
States requested the United States Congress to approve the
allocation of an historic sum of $46.1 billion for National
Drug Control Program agencies in 2024. The budget request
for the fiscal year 2024 represents a significant increase in
comparison with previous years. In addition to leading a
coordinated global effort to disrupt the illicit trade in syn-
thetic drugs, the budget foresees greater funding to support
the expansion of prevention, treatment, harm reduction and
recovery support services in the country.
559. The overdose crisis continued to have a significant
impact across Canada, with health-care and social services
being overburdened owing to the high toxicity and unpre-
dictable content of illicit drugs being consumed. Since 2017,
the Government of Canada has allocated more than 1 billion
Canadian dollars to increase access to evidence-based treat-
ment and services, as well as to raise awareness and prevent
drug use and associated stigma. In the 2023 federal budget,
a significant amount was allocated to support a renewed
Canadian Drugs and Substances Strategy and strengthen the
public health-care system, including by increasing access to
mental health and substance use services and implement-
ing harm reduction, treatment and recovery strategies for
people who use drugs.
560. On 17 November 2022, Bill C-5, amending the
Criminal Code and the Controlled Drugs and Substances
Act of Canada, received royal assent. The amendment
repeals mandatory minimum penalties for all drug-related
offences, aiming to increase the use of conditional sentences
and require prosecutors to consider alternatives to laying
or proceeding with criminal charges for simple possession
of drugs. One of the stated motivations behind the amend-
ment was to promote fairer and more effective responses
to criminal conduct and address systemic racism and dis-
crimination in the criminal justice system of Canada, while
maintaining public safety.
561. On 21 January 2023, an exemption from parts of the
Controlled Drugs and Substances Act for the Province of
British Columbia came into effect. The three-year exemption
allows the province to not bring criminal charges against
E/INCB/2023/2.
E/INCB/2023/3.
E/INCB/2023/4.
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INCB REPORT 2023
adults (aged 18 years and older) for the possession of a
combined total of 2.5 grams of opioids, cocaine, metham-
phetamine and MDMA. The exemption does not apply in
certain circumstances, including if adults in possession of
any quantity of those substances are found on the prem-
ises of schools, at licensed childcare facilities or in airports,
where they could be charged with a criminal offence. The
province is monitoring implementation, early outcomes,
public awareness and unintended consequences, and the
federal Government is carrying out assessments through
the Canadian Institutes of Health Research.
562. In March 2023, in response to the overdose crisis in
Toronto, Canada, the city’s public health authority, Toronto
Public Health, updated its submission to Health Canada for
an exemption under the Controlled Drugs and Substances
Act to decriminalize possession of drugs for personal use
in the city. If granted, the exemption would remove crimi-
nal charges for possession for personal use without use of
any alternative sanctions. The exemption would apply to
all drugs and substances listed in the Act, to all people,
including young people (people aged 12 to 17) and to all
areas of Toronto, except for childcare facilities, schools and
airports. The exemption would also create a system of vol-
untary referrals to health and social support services. The
original request for an exemption has been pending with
Health Canada since January 2022.
563. A number of companies received approval from
Health Canada amending their dealer’s licence, allowing
them to legally possess and produce limited amounts of
controlled substances, such as psilocybin, cocaine, coca
leaf, opium, morphine and diacetylmorphine, and to sell
and distribute them in limited amounts to licensed dealers,
such as pharmacists, practitioners, hospitals or holders of
an exemption for research purposes under section 56 (1) of
the Controlled Drugs and Substances Act.
564. The Health Department of the Province of Alberta
put in place a regulatory framework for the medicinal use of
psychoactive substances (psychedelics), becoming the first
province in Canada to introduce requirements and medi-
cal oversight for such use. As of 16 January 2023, service
providers are required to hold a licence under the Mental
Health Services Protection Act, except if taking part in an
approved clinical research trial, and must meet quality and
safety requirements under provincial regulations. In addi-
tion to Alberta, clinics providing psychedelic-assisted ther-
apy have also opened in the Province of British Columbia.
565. In view of the lack of federal clinical practice guide-
lines, Health Canada issued information on its expectations
regarding risk-management measures for clinical trials
involving psychedelic-assisted therapy in December 2022,
based on some best practices emerging in literature.
Measures included adequate training of therapists, the
requirement to report any serious unexpected adverse
drug reactions to Health Canada and the existence of writ-
ten informed consent from every person and every product
used in the trials, in order to meet good manufacturing
practices.
566. Developments regarding access to some psychedelic
substances have also taken place in the United States. In
April 2023, Bill No. 5263, relating to access to psilocybin
services by individuals 21 years of age and older, was passed
by the legislature of the State of Washington. However, the
Governor of the State partially vetoed the bill because of
provisions conflicting with other regulations, including
federal law obligations. This limits the scope of the bill to
research in the medical use of psilocybin and, potentially,
to a pilot programme pending the release of a final report
by the Washington State Health Care Authority expected in
December 2023. Bills related to psilocybin have been intro-
duced in an additional 18 states in the country.
567. In May 2023, the Governor of the State of Colorado
signed the Natural Medicine Legalization and Regulation
(Bill SB23-290), which establishes the regulatory framework
for licensing the cultivation, manufacture, testing, storage,
distribution, transport, transfer and dispensation of natural
medicine and natural medicine products. The licensing of
facilitators, healing centres and other licensees is to begin
no later than 31 December 2024. The legislation concerns
psilocyn and psilocybin only, however, the range of sub-
stances will be expanded to dimethyltryptamine, ibogaine
and mescaline (excluding lophophora williamsii (“peyote”))
after 1 June 2026.
568. In May 2023, the Oregon Health Authority issued the
first psilocybin service centre licence, in implementation
of the state’s Psilocybin Services Act. Under the Act, upon
completion of a preparation session with a licensed facilita-
tor, persons 21 years of age or older may access psilocybin
services without prescription or referral from health-care
providers. In addition, service centres will sell psilocybin
products.
569. In Mexico, a commission to fight trafficking in illicit
synthetic drugs, firearms and ammunition was created pur-
suant to a presidential decree issued on 12 April 2023. The
commission aims to improve coordination among govern-
ment entities of Mexico to support the investigation and
arrest of individuals involved in the production and traf-
ficking of fentanyl.
570. On 29 May 2023, Mexico established the
National Commission on Mental Health and Addictions
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(CONASAMA), a decentralized administrative body of the
Ministry of Health. The Commission merges activities previ-
ously carried out by the Technical Secretariat of the National
Mental Health Council (STCONSAME), the Psychiatric
Care Services (SAP) and the National Commission against
Addictions (CONADIC). The Commission develops policy,
strategies and programmes for the prevention and treatment
of mental health disorders, including drug use disorders. It
is also responsible for the operation of the Observatory of
Mental Health and Addictions of Mexico, which collects,
analyses and interprets information on mental health and
the consumption of drugs, with the aim of obtaining reli-
able national- and state-level data for decision-making.
The Commission was established in implementation of the
health policy priorities of the General Health Law, adopted
in May 2022.
571. In May 2023, the Federal Law for the Control of
Chemical Precursors, Essential Chemical Products and
Machines for the Manufacture of Capsules and Tablets
of Mexico was amended. The amendment strengthens
actions aimed at controlling the production, preparation,
disposal, acquisition, import, export, transportation, storage
and distribution of chemical precursors, essential chemi-
cal products and related equipment through inter-agency
coordination.
572. Following the launch of the review of the Cannabis
Act by the Minister of Health and the Minister of Mental
Health and Addictions of Canada in September 2022, an
expert panel was formed to undertake an assessment of
the legislative framework governing cannabis, engage with
stakeholders to gather perspectives to inform the review, and
provide expert advice on aspects of the legislative frame-
work and its implementation that the Government could
prioritize for improvement or reform.
573. The expert panel received a series of recommenda-
tions from various stakeholders, including the Canadian
Centre on Substance Use and Addiction and industry repre-
sentatives, as part of the consultation process for the review
mechanism. The recommendations submitted to the panel
incorporated issues related to improving competition within
the cannabis industry, including the review of the licens-
ing process and related costs; adjustments to THC limits;
the review of cannabis promotion, packaging and labelling;
surveillance of online cannabis distribution; and research on
the equitability of access, the availability of the legal supply
and pricing.
574. On 2 December 2022, amendments to the Cannabis
Act and its regulations concerning cannabis research and
testing and beverages containing cannabis came into force
in Canada. The amendments increase the public possession
limit for cannabis beverages from 2.1 to 17.1 litres, a level
similar to that of other cannabis products, such as edibles.
Existing controls aimed at mitigating the risks of over-
consumption and accidental consumption, such as child-
resistant packaging and strict limits on the amount of THC
per container, remain unamended. The amendments also
facilitate non-therapeutic cannabis research involving human
participants and allow analytical testing licence holders and
federal and provincial governmental laboratories to produce,
distribute and sell reference standards and test kits.
575. In April 2023, the Supreme Court of Canada ruled
that the provisions of the provincial law banning the pos-
session and cultivation of cannabis plants in Quebec for
personal purposes are valid and operative under the
Constitution of Canada. While the Federal Cannabis Act
allows people to possess or cultivate four cannabis plants
at home, the Cannabis Regulation Act of Quebec prohibits
such possession and cultivation. In a unanimous ruling, the
Court ruled that banning the possession of cannabis plants
and their cultivation at home is a means of achieving the
provincial law’s public health and security objectives and
such legislation is within the provinces’ jurisdiction over
property and civil rights and residual jurisdiction over mat-
ters of a local or private nature.
576. In the United States, as at 1 November 2023, 38 states,
three territories and the District of Columbia allowed the
medical use of cannabis products. On 31 March 2023, the
Governor of the State of Kentucky signed into law Senate
Bill 47, authorizing the medical use of cannabis in the state.
The use of cannabis for medical purposes would be allowed
for registered patients with qualifying medical conditions,
such as cancer, epilepsy or post-traumatic stress disorder.
Some provisions of the bill will not become effective until
1 January 2025.
577. In July 2023, the United States Department of
Veterans Affairs issued Directive 1315, on access to Veterans
Health Administration clinical programmes for veterans
participating in State-approved cannabis programmes.
Under the directive, health-care providers under the
Department discuss relevant clinical information regard-
ing cannabis use with veterans who request information
or report cannabis use and document such information
in the veteran’s electronic health record. Clinical treat-
ment decisions in relation to cannabis use must be made
on a case-by-case basis and take into account the health
and safety of veterans. Furthermore, veterans must not
be denied Veterans Health Administration services solely
because they are participating in a State-approved cannabis
programme or because they acknowledge that they use can-
nabis. However, to comply with federal law, Veterans Health
Administration health-care providers are prohibited from
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INCB REPORT 2023
recommending or registering veterans for participation in a
State-approved cannabis programme, completing forms for
them to that end, or making referrals to such programmes.
578. As at 7 November 2023, 24 states, two territories and
the District of Columbia had enacted measures to regulate
the use of cannabis for non-medical purposes. Most recently,
the State of Delaware passed Bills HB1 and HB2. Both bills
became law on 23 April 2023, without the signature of the
Governor of the state, owing to his reservations regarding
legalization. Persons over the age of 21 are allowed to pos-
sess, use, display, purchase or transport cannabis without
penalty, and the legislation also establishes a regulated, taxed
market for cannabis for recreational use similar to that for
alcohol. Bill H.F.100, establishing a regulatory framework
for the use by adults of cannabis for non-medical purposes,
including a regulated market with taxation on cannabis
products, was enacted in the State of Minnesota on 30 May
2023. The “issue 2” ballot initiative in a referendum held
in the State of Ohio on 7 November 2023 was approved by
voters. The initiative modifies Ohio law and allows for the
possession and personal cultivation of cannabis as well as
the licensing of cannabis growers and retailers.
579.
INCB underscores that article 4 (c) of the 1961
Convention requires States parties to take such legisla-
tive and administrative measures as may be necessary,
subject to the provisions of the Convention, to limit exclu-
sively to medical and scientific purposes the production,
manufacture, export, import, distribution of, trade in,
use and possession of drugs, and that article 3 of the 1988
Convention requires States parties to adopt such meas-
ures as may be necessary to establish as criminal offences
under its domestic law, when committed intentionally:
(a)
The production, manufacture, extraction,
preparation, offering, offering for sale, distribution, sale,
delivery on any terms whatsoever, brokerage, dispatch,
dispatch in transit, transport, importation or exporta-
tion of any narcotic drug or any psychotropic substance
contrary to the provisions of the 1961 Convention, the
1961 Convention as amended or the 1971 Convention;
(b)
The cultivation of cannabis plant for the
purpose of the production of narcotic drugs contrary
to the provisions of the 1961 Convention and the 1961
Convention as amended.
580. The proclamation by the President of the United
States, who announced on 6 October 2022 a full, uncondi-
tional and categorical pardon for prior offences of simple
possession of cannabis under federal law and the law of the
District of Columbia, is being implemented by the United
States Department of Justice. While the presidential pardon
does not expunge the existing conviction, it removes civil or
legal restrictions, such as on the rights to vote, hold office or
sit on a jury, and lifts barriers to housing, employment and
educational opportunities.
581. As of March 2023, a cannabis company was author-
ized to import and acquire cannabis seeds and cultivate,
produce and sell cannabis products with low levels of THC
in Mexico. This is the first authorization related to com-
mercial cannabis issued by the Federal Commission for
the Protection against Sanitary Risks (COFEPRIS), the
heath regulatory agency of Mexico. The authorization was
granted by the Commission in response to a decision by
the Supreme Court of Mexico. In a public statement, the
Commission emphasized that it did not have enough infor-
mation to determine that future products would be safe for
the purposes for which the company intended them to be
used. In addition, the Commission, in coordination with the
Ministry of Interior, filed complaints and non-conformity
appeals seeking to reverse and invalidate the authorization
in order to protect public health.
5.
Cultivation, production,
manufacture and trafficking
582. According to the 2022
Public Report on Organized
Crime in Canada,
cocaine remained the primary commodity
trafficked in Canada, and organized crime involvement in
the markets for methamphetamine and fentanyl continued
to increase. More than 350 organized crime groups were
involved in the illicit market for fentanyl in Canada, while
21 such groups were involved in its illicit manufacture.
583. In December 2022, the Canada Border Services
Agency seized nearly 2.5 tons of opium in Vancouver, British
Columbia, the largest opium seizure by the agency to date.
In addition, between 13 April and 14 May 2023 alone, the
Agency made 15 seizures of ketamine, amounting to 89.8 kg,
with a street value of over 6 million Canadian dollars. All the
seizures were made at the Léo-Blanchette Mail Processing
Centre.
584. There have been significant seizures of fentanyl by
various law enforcement agencies in the United States. In
2022, the United States Drug Enforcement Administration
seized a total of more than 57 million fentanyl-laced
counterfeit prescription pills and nearly 6,000 kg of fentanyl
powder. An additional 6,800 kg of fentanyl was seized by the
United States Customs and Border Protection. The Drug
Enforcement Administration estimated that the seizures
amounted to over 379 million deadly doses of fentanyl. The
United States Postal Inspection Service seized approximately
150 per cent more fentanyl in 2022 than in the previous year
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and the Office of Foreign Assets Control of the United States
Department of the Treasury designated nearly 100 individu-
als and entities for their role in the illicit drug trade, includ-
ing trafficking in fentanyl and precursor chemicals.
585. According to data from the High-Intensity Drug
Trafficking Areas programme, between the last quarter
of 2021 and 30 September 2022, law enforcement offi-
cials seized more than 11 tons of fentanyl, nearly 3 tons of
heroin, more than 150 tons of methamphetamine and nearly
170 tons of cocaine, representing nearly $9 billion in street
value. The programme oversees 33 regional areas in all 50
states of the United States, as well as Puerto Rico, the United
States Virgin Islands and the District of Columbia.
586. In the United States, seizures of illicit ketamine by
drug enforcement agencies rose by 349 per cent between
2017 and 2022. In 2023, the United States Customs and
Border Protection seized over 6 tons of ketamine, compared
with 4.9 tons in 2022.
587. Fentanyl and methamphetamine seizures in Mexico
increased in 2021, in comparison with 2020. The National
Guard seized 168 kg of fentanyl in 2021, whereas less than
50 kg of the substance were seized in 2020. The quantity of
methamphetamine seized reached more than 4.7 tons in
2021, compared with 1.36 tons in 2020. On the other hand,
seizures of cocaine, cannabis, heroin and other psychotropic
substances decreased.
588. Seized equipment and illicit narcotic drugs have
been continuously destroyed in various regions in Mexico,
often in large quantities. On 25 June 2023, the Office of
the Attorney General of Mexico, through the Specialized
Regional Control Prosecutor’s Office (FECOR), in its
Sinaloa Delegation, destroyed nearly 36 tons of various
narcotic drugs and precursor chemicals and over 735,000
fentanyl pills, in addition to drug manufacturing equipment.
589. The illicit manufacture of and trafficking in drugs
among cartels and criminal gangs continue to contribute
to high levels of violence in Mexico. According to UNODC
data, although intentional homicide rates in the country
have fallen slightly over the past several years, the homicide
rate remains one of the highest among countries worldwide,
with more than 28 homicides per 100,000 people in 2021.
Available data for 2022 and 2023 suggest that the rates of
violence and homicide in the country have remained at the
levels of 2021.
6. Prevention and treatment
590. According to the United States Centers for Disease
Control and Prevention, drug overdose deaths in the United
States have risen fivefold over the past two decades. In 2021,
there were over 106,000 deaths due to overdose of drugs,
including illicit drugs and prescription opioids. The number
of drug overdose deaths involving synthetic opioids other
than methadone continued to increase, reaching more
than 70,000 deaths in 2021, while deaths involving heroin
declined from nearly 13,200 in 2020 to nearly 9,200 in 2021.
In comparison, provisional data for 2022, published in May
2023, show that the overall reported number of drug over-
dose deaths occurring in the United States slightly decreased
from 2021 to 2022. However, drug overdose deaths involv-
ing synthetic opioids (including fentanyl but excluding
methadone) and stimulants with abuse potential (such as
methamphetamine) continued to increase in comparison
with 2021. The Board stresses the importance of the avail-
ability of and access to overdose-reversing medications, such
as naloxone, which, if administered in a timely manner, have
life-saving effects.
591. According to data released by Health Canada, there
were a total of nearly 7,400 apparent opioid toxicity deaths in
Canada in 2022, with over 2,200 such deaths in the Province
of British Columbia alone. That was the second largest
number of suspected deaths ever recorded in a calendar year
in that province, after the more than 2,300 deaths recorded
in 2021. Of all accidental apparent opioid toxicity deaths in
2022, 81 per cent involved fentanyl and more than half also
involved a stimulant (cocaine or methamphetamine), reflect-
ing the polysubstance nature of the crisis in the country.
592. In the United States there has also been an increas-
ing concern over overdoses involving opioids laced with
other substances, including stimulants and benzodiazepines
or analogues. In March 2023, the United States Drug
Enforcement Administration issued a public safety alert
on the sharp increase in the trafficking of fentanyl mixed
with xylazine. The Administration reported that it had
seized xylazine and fentanyl mixtures in 48 states and that,
in 2022, approximately 23 per cent of the fentanyl powder
and 7 per cent of the fentanyl pills it had seized contained
xylazine. On 12 April 2023, the Government of the United
States officially designated fentanyl adulterated or associated
with xylazine as an emerging threat to the country, owing
to the associated significant and rapidly worsening negative
health consequences, including fatal overdoses and severe
morbidity. Xylazine is a sedative approved for veterinary use
in Canada and the United States.
593. Xylazine has also been identified in an increasing
number of samples taken by law enforcement agencies across
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Canada. According to Health Canada, the proportion of
fentanyl samples that also contained xylazine increased from
1.4 per cent in January 2020 to 9 per cent in April 2023, with
a peak near 12 per cent in June 2022. In addition, a number
of provinces across Canada have issued toxic drug alerts
about bromazolam having been detected in blood samples
taken in investigations into sudden deaths; in some cases,
the bromazolam had been laced with fentanyl. Bromazolam
is a benzodiazepine not under international control. It is
not approved for medical use in Canada. Naloxone, which
is commonly used to counteract the effects of opioids and
prevent overdose, does not reverse the effects of xylazine or
benzodiazepines.
594. In implementation of its National Drug Control
Strategy, the Government of the United States has acceler-
ated a series of public health initiatives, in addition to actions
targeting drug supply reduction. The initiatives include
expanding the availability of and access to opioid overdose
reversal products, including through the first approval of
naloxone as a non-prescription drug, on 29 March 2023,
by the United States Food and Drug Administration and
by delivering naloxone to communities adversely affected
by fentanyl. On 6 April 2023, the Government launched
a national campaign to educate young people about the
dangers of fentanyl and the life-saving effects of naloxone
and has been working to make treatments for opioid use
disorders a part of routine health-care delivery, including
in prison settings.
595. On 22 May 2023, the United States Food and Drug
Administration approved the first nalmefene hydrochlo-
ride nasal spray for the emergency treatment of known or
suspected opioid overdose in adults and paediatric patients
aged 12 years and older. It is the first approval of the sub-
stance for use in health-care and community settings in the
United States. The approval was supported by safety and
pharmacokinetic studies and the nasal spray was subject to
a priority review, which allows approval within 6 months,
instead of the 10 months required under standard review
procedures.
596. To further address the drug overdose crisis in the
United States, the National Institutes of Health has estab-
lished a research network that will test harm reduction strat-
egies, such as the distribution of naloxone and fentanyl test
strips, in different community settings and will examine the
efficacy of bringing harm reduction services and tools into
communities by means of, or in the form of, mobile vans,
peer support specialists, Internet- and smartphone-based
tools and other types of outreach. The initiative is expected
to provide a total of approximately $36 million over five
years and represents the largest pool of funding to date for
that purpose.
597. The National Institute on Drug Abuse awarded New
York University Langone Health and the Brown University
School of Public Health with a grant to conduct research to
measure the impact of some of the first publicly recognized
overdose prevention centres in the United States, located
in New York City and Providence, Rhode Island. As part of
the research project, the first of its kind, the three sites are
being evaluated between 2023 and 2027 in terms of fatal
and non-fatal overdose rates and emergency department
visits. In addition, the project is examining the community
impact of the sites and estimating their operational costs
and the potential cost savings they provide to health-care
and criminal justice systems.
598. According to the United States 2022 Monitoring the
Future survey, published in June 2023, levels of adolescent
cannabis use in the United States decreased after the onset
of the COVID-19 pandemic in 2021 and remained rela-
tively stable in 2022, with 31 per cent of 12th-grade students
reporting cannabis use in the past 12 months. The use of
narcotic drugs other than heroin increased slightly among
12th-grade students between 2021 and 2022, with 1.7 per
cent reporting such use within the past year. Among the
same group of students, the prescribed use of medications
for attention deficit and hyperactivity disorder increased
from 11 per cent in 2021 to 15 per cent in 2022. Building
on results from the Monitoring the Future survey, the
University of Michigan and Columbia University under-
took a study that showed that young adults aged 19 to 30
years had nearly doubled their past-year use of non-LSD
hallucinogens between 2018 and 2021, with past-year use
at 3.4 per cent in 2018, compared with 6.6 per cent in 2021.
599. The 2022 Canadian Cannabis Survey results were
published in December 2022. Most of the findings did not
differ significantly from those of 2021. A new parameter on
accidental consumption of cannabis was introduced in the
2022 survey. Among people who had used cannabis in the
past 12 months, over 30 per cent indicated higher THC and
lower CBD consumption, and over 60 per cent had obtained
cannabis from a legal storefront, an increase from 53 per cent
reported in the 2021 survey. Five per cent of respondents
reported always obtaining cannabis from illegal or unlicensed
sources, with online illegal markets remaining attractive
owing to the ease of payment and the appearance of being a
legal source. Most respondents also indicated that the occa-
sional use of alcohol and cannabis posed no or only a slight
risk, whereas the occasional smoking of tobacco and use of
e-cigarettes with nicotine posed moderate or great risks.
600. In a report released on 29 March 2023, the Canadian
Centre on Substance Use and Addiction concluded that
substance use had cost the Canadian economy over 49 bil-
lion Canadian dollars in 2020, up from 11 billion Canadian
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dollars per year between 2007 and 2020. Lost productivity,
including the value of work lost due to premature deaths
and long- and short-term disability, had cost over 22 billion
Canadian dollars in 2020, with opioid use having cost over
7 billion Canadian dollars in 2020, higher than in any other
year. The report also analysed the related costs of health care
and criminal justice and other direct costs.
601. In Canada, between April 2018 and March 2023,
the “Know more” opioids awareness programme engaged
in more than 1,300 in-person and virtual sessions at high
schools, 68 events at post-secondary institutions, 43 events
and festivals and more than 175,000 interactions with people,
and placed awareness products such as posters and wallet
cards in high-traffic areas of 16 post-secondary educational
institutions. The programme raises the awareness of teenagers
and young people across Canada about the facts surround-
ing the opioid overdose crisis, opioids, fentanyl, signs of an
overdose, naloxone, the Good Samaritan Drug Overdose Act
and the impacts of stigma on people who use drugs.
602. As of June 2023, there were 38 supervised drug con-
sumption sites operating in Canada, and an additional 10
sites were awaiting approval by Health Canada. The sites pro-
vide health, social and treatment services, including access to
clean drug use equipment, drug checking, emergency medi-
cal care in case of overdose, testing for infectious diseases,
referrals for drug treatment and access to social services such
as housing. Since 2017, there have been over 4 million visits
to the sites and over 40,000 overdoses have been reversed at
the sites. As possession of controlled substances is prohibited
under the Controlled Drugs and Substances Act, an exemp-
tion under section 56 (1) of the Act is required to operate a
supervised consumption site for medical purposes.
603. To facilitate access to prevention and health services
for people who use drugs, the Inter-Institutional Committee
for Risk and Harm Reduction was established in Mexico
City in January 2023. The Committee comprises mem-
bers from the National Commission against Addictions
(CONADIC), the Psychiatric Care Services (SAP) and the
Technical Secretariat of the National Mental Health Council
(STCONSAME) of the Ministry of Health, the government
of Mexico City and the Human Rights Commission of
Mexico City, and is supported by civil society organizations.
The purpose of the Committee is to ensure that prevention
and treatment services for people who use drugs in the city
are undertaken with respect for human rights and aim to
decrease associated stigma.
604. According to the National Institute of Statistics
and Geography (INEGI) of Mexico, in 2021, the Attorney
General charged over 3,200 adolescents with alleged drug-
related crimes, of which 90 per cent were charged for simple
possession of controlled substances, in particular cannabis
and methamphetamine. Drug-related crimes represented a
total of 14.4 per cent of the total number of criminal charges
against adolescents in that year and were the third most
common type of crime among that population, after robbery
and various injuries. In comparison with 2015, the number
of adolescents charged with alleged drug-related offences
decreased by 23 per cent.
605. According to the Observatory of Mental Health
and Addictions of Mexico, Mexico is going through an
epidemiological transition in terms of the demand for
treatment for use of methamphetamine, experiencing an
increase in admissions for treatment in a greater number
of states. In 2017, six states noted admissions for use of
methamphetamine, which increased to 21 states in 2022.
Between those years, the use of methamphetamine, ecstasy
and stimulants increased by 218 per cent. In 2022, those
substances accounted for over 46 per cent of requests for
treatment.
606. According to the “Online survey on the use of can-
nabis and derivatives” carried out in Mexico in 2023, which
was taken by nearly 13,500 people between the ages of 12
and 75, 28.3 per cent of survey respondents had used can-
nabis at some time in their lives and one in five identified
herself or himself as a current user. The main reasons given
for use included sleep and performance enhancement, stress
reduction, socialization and experimentation.
South America
Drug trafficking organizations continue to expand their
operations in the Amazon Basin into illegal mining, illegal
logging and wildlife trafficking, resulting in life-threatening
risks to Indigenous populations. Such activities have been
linked to bribery, extortion, fraud and money-laundering,
as well as homicide, violent assault, sexual violence and
forced labour in the Amazon.
The area under illicit coca bush cultivation in Colombia
rose by 13 per cent to a second consecutive record high of
230,000 ha, while a record level of 95,008 ha of illicit coca
bush cultivation was reported in Peru for 2022, represent-
ing an 18 per cent increase compared with 2021 and taking
place most notably in the Peruvian Amazon.
The Secretary-General of the united Nations received a
request from the Plurinational State of Bolivia to activate
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INCB REPORT 2023
the process for a critical review of the current classification
of coca leaf as a narcotic drug in Schedule I of the 1961
Convention as amended.
in Amazonas Department. According to the Ombudsman,
these communities are at risk of violations of their right to
life, freedom, integrity and security, including violations of
international human rights law.
610. Drug-related crime and other forms of organized
crime continue to affect politics in South America to dif-
ferent degrees, as illustrated by recent developments and
ongoing investigations related to Ecuador and Venezuela
(Bolivarian Republic of). In July 2023, Hugo Armando
Carvajal Barrios, former director of the military intelligence
agency of the Bolivarian Republic of Venezuela, was extra-
dited by Spain to the United States for allegedly participating
in drug-trafficking activities. He is charged with participat-
ing in a narco-terrorism conspiracy; conspiring to import
cocaine into the United States; using, carrying and possess-
ing machine guns and destructive devices in connection
with narco-terrorism and cocaine importation conspiracies;
and conspiring to use, carry and possess machine guns and
destructive devices in connection with narco-terrorism and
cocaine importation conspiracies.
611. In Ecuador, presidential candidate Fernando
Villavicencio was murdered on 9 August 2023 after par-
ticipating in a campaign rally. The violent act also left nine
other people injured, including a candidate for the legislature
and two police officers. Villavicencio held strong positions
against drug cartels, criminal organizations and corruption.
The homicide was declared a political crime by Ecuadorian
President Guillermo Lasso, who also declared three days of
national mourning and 60 days of state of exception.
612. In January 2023, the Attorney General’s Office of
Colombia announced the arrest of Margareth Chacón, a
Colombian national accused of planning and financing
the murder of a Paraguayan public prosecutor, Marcelo
Daniel Pecci Albertini, who successfully pursued several
high-profile organized crime cases. The homicide was
committed in Colombia and Chacón had met with drug
trafficking organizations in Mexico before leading the assas-
sination in Cartagena, Colombia, and subsequently fleeing
to El Salvador, where she was arrested.
613. In Brazil, the Brazilian directory of public security was
published in July 2023. The report tracks violent intentional
deaths at the national and state levels and analyses police
lethality as well as casualties among the police forces. Data
provided in the report also cover disappearances, violence
against children and youth, domestic and sexual violence,
firearms and public security spending. The report presents a
trend of intentional violent deaths in Brazil since 2011, which
peaked in 2017 with 67,078 deaths, decreasing in 2018 and
2019, falling to 47,765 deaths, and then remained relatively
stable until 2022, when 47,398 such deaths were recorded.
1.
Major developments
607. South America is one of the three regions in the world
that suffer the highest economic impacts of armed conflict,
including between militias and drug cartels, together with
the Middle East and North Africa and sub-Saharan Africa.
Moreover, the effects of drug trafficking on the environment
and the life of Indigenous communities are increasingly vis-
ible in the region.
608. Most notably, in the Amazon regions in Brazil,
Colombia and Peru, which combined account for 79 per
cent of the Amazon basin, drug trafficking organizations
continue to expand their operations into illegal mining, ille-
gal logging and wildlife trafficking. In the
World Drug Report
2023,
UNODC described the nexus connecting drug-related
crime, crimes that affect the environment and convergent
crime, which includes bribery, extortion, fraud and money-
laundering, as well as homicide, violent assault, sexual vio-
lence and forced labour. This complex set of challenges
affects the environment through a phenomenon known
as narco-deforestation, which poses a significant threat to
the world’s largest rainforest and disproportionately affects
Indigenous Peoples, people of African descent and other
vulnerable populations through forced displacements, mer-
cury poisoning and increased exposure to violence.
609. In Colombia, the presence of dissident factions of
the former Revolutionary Armed Forces of Colombia –
People’s Army (FARC-EP), namely, the Carolina Ramírez
First Front and the Armando Ríos First Front, has been
linked to numerous accounts of homicides, threats, extor-
tions, forced recruitment of minors, internal displacements
and other violent crimes. The violence is connected to dis-
putes for territory and internal control of the factions, as
well as the social control imposed by the organizations on
local communities, and it affects mostly Indigenous popu-
lations. The violence is further fuelled by the presence of
the Brazilian criminal organizations Red Command and
First Command of the Capital, which collaborate with the
Colombian organizations in order to traffic illicit substances
and illicit mining spoils across the border. The Colombian
Ombudsman issued
alerta temprano de inminencia
(early
imminence alert) No. 0-17-23 in May 2023, demanding
the prioritization of exceptional preventive humanitar-
ian support to Indigenous communities in the Colombian
Amazon, including the Yaigojé Apaporis Reserve in Vaupés
Department, and the communities in the non-urban areas of
La Pedrera, La Victoria, Mirití-Paraná and Puerto Santander
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Regarding the regional distribution of intentional violent
deaths, the highest violent homicide rates were registered
in Amapá, with 50.6 deaths per 100,000 population, Bahia
(47.1) and Amazonas (38.8), in the north and north-east
regions of the country. The report also presents an analysis
linking the widespread violence in the country to the expan-
sion of activities of the rival drug trafficking organizations
– Red Command and First Command of the Capital – from
their original territories in south-eastern Brazil (namely in
Rio de Janeiro and São Paulo) into other states.
614. During the fifty-fourth session of the Human Rights
Council of the United Nations in September and October
2023, the independent international fact-finding mission
on the Bolivarian Republic of Venezuela presented its third
report (A/HRC/54/57), focusing on two areas:
(a)
the State
apparatus and its mechanisms of repression and restrictions
on civic and democratic space; and
(b)
the establishment of
the Directorate of Strategic and Tactical Actions as part of
the Bolivarian National Police in July 2022 as the continua-
tion, in terms of structure, command and modus operandi,
of the Special Action Forces (FAES). In the report, it is stated
that the mission remains concerned about the great number
of allegations of extrajudicial executions by security forces in
the context of security operations against organized crime.
615. On 26 June 2023, the President of the Plurinational
State of Bolivia sent a letter to the Secretary-General of the
United Nations requesting to begin the process of a critical
review of the current classification of coca leaf as a drug in
Schedule I of the 1961 Convention as amended, in accord-
ance with article 3 of the Convention. In accordance with the
same article, the request was brought to the attention of the
parties, WHO and the Commission on Narcotic Drugs by
the Secretary-General. The Government of the Plurinational
State of Bolivia will be notified once the review by WHO
has been completed. The Plurinational State of Bolivia has a
reservation to the 1961 Convention that allows the chewing
of coca leaf for cultural purposes in its national territory.
The Government constitutionally protects ancestral coca as
cultural heritage, a renewable natural resource for biodiver-
sity and a factor of social cohesion, and does not consider it
to be a narcotic drug when in its natural state. The General
Coca Law establishes a production limit of up to 22,000 ha
of coca bush, as well as the authorized production areas with
geo-referenced limits.
System of Colombia, the National Police of Colombia and
Brazilian law enforcement agencies. The project has held five
technical workshops and trained around 300 representatives
from security forces in four states of Brazil. The project aims
to build a broader and more diversified monitoring system
for the illicit drug market, with a focus on price and purity
information. The initiative is part of the Centre of Excellence
for the Reduction of the Illicit Drug Supply, a partnership
between UNODC, the Brazilian National Secretariat for
Drug Policy (SENAD) and UNDP.
617. Moreover, in 2022, the Global Programme on
Cybercrime, in cooperation with the UNODC Laboratory
and Scientific Service published, under the UNODC opioid
strategy, a report entitled “The online trafficking of syn-
thetic drugs and synthetic opioids in Latin America and
the Caribbean”. This report has provided information on
how organized criminal groups have used social media
platforms, open forums and darknet markets for all phases
of trafficking, from acquiring the precursors needed to
manufacture synthetic drugs to selling the final products
and monetizing revenues mainly through cryptocurrencies.
618. During 2022 and 2023, UNODC supported Colombia,
the Dominican Republic, Jamaica, Mexico, Paraguay and
Peru in addressing the whole cycle of drug trafficking inves-
tigation in cyberspace, from the initial phases of a case to the
trial. In this regard, 14 training courses were delivered focus-
ing on legal aspects of the implementation of investigative
techniques in cyberspace, challenges from the theory of the
case to trial, blockchain, cryptocurrencies, the darknet, and
forensic analysis in all its phases, with practical exercises and
live demonstrations.
619. In January and April 2023, UNODC facilitated
the exchange of best practices on asset forfeiture between
Bolivian prosecutors, counter-narcotics police and offi-
cials of seized assets (Directorate for the Registry, Control
and Administration of Seized Assets) and the Colombian
Police and Prosecutor’s Office. In August 2023, 40 offic-
ers of the Special Force against Drug Trafficking and the
Regional Centre for Anti-Narcotics Intelligence, based in
the Plurinational State of Bolivia, participated in an inter-
national course on investigation and financial analysis. The
training was conducted by the Federal Police of Brazil and
strengthened participants’ skills in the use of financial analy-
sis techniques and technologies in the fight against organ-
ized crime related to drug trafficking.
620. UNODC promoted a bilateral meeting between pros-
ecutors from Argentina and Bolivia (Plurinational State of)
in May 2023. The meeting was aimed at facilitating interac-
tion among border prosecutors and making progress in the
formation of joint investigation teams. This activity was a
2.
Regional cooperation
616. In 2022, cooperation between Brazil and Colombia
was promoted through a pilot project for monitoring the
illicit drug market in Brazil, implemented by UNODC in
collaboration with the Integrated Illicit Crop Monitoring
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INCB REPORT 2023
continuation of the border visit made by UNODC to the city
of Yacuiba, Plurinational State of Bolivia, in 2022.
621. On 13 December 2022, the Centre of Excellence of
Brazil, jointly with the Integrated Illicit Crop Monitoring
System of Colombia, published the study entitled “Dynamics
of the illicit drug market in Brazil: comparative analysis of
the prices of cannabis herb, cocaine and other drugs” in
four States in Brazil. The study found that risks associated
with each stage of the process, such as conflicts in the terri-
tory, customs controls and police action, could contribute
to variations in drug prices. The study also found that dis-
putes between different organized criminal groups, as well
as the hegemony of an organization, could also influence
price variation. For example, it was found that the price of
cocaine base in Brazil increased as the product was trans-
ported further from the drug-producing countries.
622. In December 2022, Argentina hosted the forty-sixth
plenary meeting of the Financial Action Task Force of
Latin America, which supports countries in strengthening
measures to tackle money-laundering and terrorist financ-
ing. The Task Force’s member States are Argentina, Bolivia
(Plurinational State of), Brazil, Chile, Colombia, Costa
Rica, Cuba, the Dominican Republic, Ecuador, Guatemala,
Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru
and Uruguay. During the meeting, the mutual evaluation
report on Ecuador was approved. Among the key findings,
the report highlighted that, considering the country’s risk
profile, although the work of the Economic and Financial
Analysis Unit was outstanding, the number of disseminated
financial intelligence reports was not appropriate given the
seriousness of the threats identified, such as drug traffick-
ing and smuggling. The plenary also approved the “Seventh
enhanced follow-up report and second technical compliance
re-rating report of Colombia”. The report recognizes the
important progress being made by the country in address-
ing the compliance deficiencies identified in its 2018 mutual
evaluation report. The country has been re-rated from par-
tially compliant to largely compliant for two recommenda-
tions on customer due diligence.
623. The UNODC-INTERPOL-WCO Passenger and
Cargo Border Team units made record seizures of precursor
chemicals in South America. As a result of the coordinated
work between Bolivia (Plurinational State of) and Chile,
690 tons of chemical precursors intended for the production
of cocaine were seized in November 2022 in 41 abandoned
containers. That was the largest seizure of chemical pre-
cursors by a Passenger and Cargo Border Team unit since
the programme’s inception in 2005 and constitutes approxi-
mately 80 per cent of the total chemical precursor seizures
by the Passenger and Cargo Border Team for the entire year
(over 830 tons).
624. In 2023, the Cooperation Programme between Latin
America, the Caribbean and the European Union on Drugs
Policies (COPOLAD III) continued to support regional and
international cooperation in drug control matters in Latin
America and the Caribbean. Activities included a workshop
for the exchange of information and intelligence and the
improvement of chemical management and disposal sys-
tems, held in Quito in April 2023; a seminar on drugs, vul-
nerabilities and urban territories, held in Fortaleza, Brazil,
in April 2023; a meeting organized by EMCDDA on the
analytical capacity of national early warning systems and
national drug observatories, including updates and new per-
spectives, held in Santiago in April 2023; and the workshop
“Road maps for quality care, social inclusion and the fight
against drug use stigma”, held in Montevideo in June 2023.
625. In December 2022, Argentina, Bolivia (Plurinational
State of), Brazil, Chile, Colombia, Paraguay and Uruguay
participated in the Board’s Operation Knockout and
exchanged intelligence to identify and dismantle illicit
manufacturing and distribution points involving non-
medical carisoprodol, 1,4-butanediol, flubromazepam,
gamma-butyrolactone
and ketamine trafficked through
the international post, express mail, courier services and
related modalities.
626. In April 2023, the GRIDS Programme held capacity-
building training for 32 enforcement officers from police,
customs and postal security in Uruguay, followed by
training for 26 Paraguayan officials. Both events covered
the safe identification and interdiction of dangerous sub-
stances. Participants also received instruction on IONICS
and GRIDS Intelligence high-definition targeting tools to
improve cross-border intelligence-sharing.
627. In May 2023, the GRIDS Programme delivered two
training courses in Brazil for 39 law enforcement and regula-
tory officers. Participants received instruction on the appro-
priate utilization of INCB operational tools and targeting
platforms, IONICS and GRIDS Intelligence high-definition,
to aid in intelligence exchange and investigation efforts.
628. In May 2023, the GRIDS Programme delivered an
awareness-raising and capacity-building workshop on the
safe interdiction of synthetic opioids and related chemicals
for 25 Peruvian front-line officers in Lima. The training
emphasized capacity-building to enhance communications
by authorities in Peru concerning safe handling and inter-
diction approaches for dangerous substances.
629. In September 2023, the GRIDS Programme organ-
ized the sixth annual operational meeting on countering
trafficking in dangerous synthetic drugs and chemicals
through postal, courier and air cargo services, in Vienna.
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The event gathered law and regulatory enforcement focal
points and forensic laboratory, chemical and toxicology
experts, including from Argentina and Chile, to assess the
latest intelligence on dangerous substances with no known
legitimate use. Several participating Governments also con-
ducted bilateral and multilateral case meetings to enhance
cooperation across borders.
630. Also in September 2023, the GRIDS Programme
convened the third international expert group meeting
on expanding INCB lists of dangerous substances with no
known legitimate use and novel approaches for their identi-
fication in falsified or illicitly manufactured pharmaceuticals
in Vienna. The event brought together representatives from
Governments and international organizations, including
from Argentina, Brazil, Chile and Uruguay. Special attention
was given to the efforts and outcomes of INCB Operation
Knockout to stop trafficking of new psychoactive substances
used to facilitates sexual assault.
631. A total of 338 drug control officials from the com-
petent national authorities of all 12 countries in South
America, namely, Argentina, Bolivia (Plurinational State of),
Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru,
Suriname, Uruguay and Venezuela (Bolivarian Republic of),
have registered to use INCB Learning e-modules. There are
now five e-modules developed by INCB Learning, which
cover narcotic drugs, psychotropic substances, precursors,
the international drug control framework and ensuring the
adequate availability of controlled substances for medical
and scientific purposes. E-modules are available upon reg-
istration through INCB Learning to officials of competent
national authorities at no cost.
632. UNODC provided training on the safe handling and
disposal of seized drugs and precursor chemicals for author-
ities in Colombia, Ecuador, Guatemala and Peru. Though
the Regional Programme for the Secure Management
and Disposal of Seized Drugs and Chemical Precursors
(STAND), UNODC also delivered national and regional
training on the control and inspection of precursor users
and promoted information exchange at the subregional level
to identify emerging trends and modi operandi of precur-
sor diversion.
the licit activity of internationally controlled substances and
assess the level of availability of these substances for licit
medical and scientific purposes.
634. In South America, as in other regions, it is difficult
to establish adequate levels of opioid analgesics without
the reliable measurement of medical needs related to pal-
liative care and other health conditions. According to data
reported to the Board by Member States, the consumption
of opioid analgesics in South America, expressed in S-DDD
per million inhabitants, has almost tripled in the last
20 years, from 6,239 S-DDD
pm
in 2002 to 16,824 S-DDD
pm
in 2021. In 2021, Chile was the country reporting the
highest consumption (2,224 S-DDD
pm
), followed by
Colombia (1,780 S-DDD
pm
), Argentina (1,672 S-DDD
pm
),
Uruguay (962 S-DDD
pm
), Brazil (704 S-DDD
pm
), Peru
(397 S-DDD
pm
), Paraguay (392 S-DDD
pm
), Ecuador
(302 S-DDD
pm
) and Suriname (230 S-DDD
pm
). The
remaining countries reported S-DDD
pm
below 200: the
Plurinational State of Bolivia reported 173 S-DDD
pm
,
while the Bolivarian Republic of Venezuela and Guyana
reported the lowest consumption in the region, with 25 and
0 S-DDD
pm
, respectively. Among the various opioids, fen-
tanyl was the most consumed in 2021 (14,456 S-DDD
pm
),
followed by morphine (1,009 S-DDD
pm
), hydrocodone
(981 S-DDD
pm
) and oxycodone (193 S-DDD
pm
). The avail-
ability levels of narcotic drugs, excluding those listed in
Schedule III of the 1961 Convention as amended, expressed
in S-DDD, are calculated by dividing annual availability by
365 days. The result obtained is divided by the population,
in millions (S-DDD
pm
), of the country or territory during
the year in question, and then by the defined daily dose.
635. In recent years, countries in South America have
demonstrated varying levels of commitment to submitting
their annual statistical report on psychotropic substances
as required by the 1971 Convention. While there have been
years with full compliance or near full compliance, some
years have seen a slight decline in the number of submis-
sions. The region continues to strive for consistent reporting
from all its members. Determining the levels of consump-
tion of psychotropic substances in South America poses
challenges because only between half and three quarters
of the countries in the region have provided consumption
data on any psychotropic substance over the past five years.
Efforts to determine availability are also hampered by the
significant proportion of countries in the region failing to
regularly provide their annual statistical report on psycho-
tropic substances.
636.
The Board recalls that there is insufficient avail-
ability of narcotic drugs and psychotropic substances in
some countries of the region and emphasizes the impor-
tance of ensuring sufficient availability of and access to
3.
Availability of internationally
controlled substances, including
reporting to the Board
633. The three international drug control treaties require
States parties to furnish statistical reports to the Board on
an annual basis. These reports enable the Board to monitor
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INCB REPORT 2023
internationally controlled substances for medical pur-
poses. The Board recognizes the efforts of countries in
the region to increase availability in their territories, as
evidenced by their increased consumption, and encour-
ages further measures, with special attention to availabil-
ity in non-urban areas and for vulnerable populations.
637. With regard to precursor chemicals, Member States
voluntarily provide estimates of their annual legitimate
requirements for imports of certain precursor chemicals
frequently used in the illicit manufacture of amphetamine-
type stimulants in the context of resolution 49/3 of the
Commission on Narcotic Drugs. Among other substances,
the provision of annual legitimate requirements is requested
for ephedrine and pseudoephedrine, substances that also
have medicinal uses, as well as, to the extent possible, for
preparations containing those substances that could be easily
used or recovered by readily applicable means. In the last
five years, all countries in South America except Paraguay
provided at least one estimate of their annual legitimate
requirements for imports of ephedrine, ephedrine prepa-
rations, pseudoephedrine or pseudoephedrine preparations
to the Board and have regularly updated their estimates for
those substances, which contributes to preventing their
oversupply and diversion into illicit channels and ensuring
their availability for legitimate purposes. Suriname provided
annual legitimate requirements to the Board for the first
time in the last five years in 2019.
governmental agencies as well as with private sector entities
involved in the control of the use of precursor chemicals.
640. In 2023, UNODC launched a programme to counter
synthetic drugs and the diversion of chemical precursors
in Argentina. The programme focuses on strengthening
interdiction of illicit drugs, with an emphasis on synthetic
drugs and new psychoactive substances, including synthetic
opioids, and also focuses on the control of chemical sub-
stances, criminal justice responses to drug trafficking on the
Internet, and criminal justice responses to corruption asso-
ciated with drug trafficking. The programme is being imple-
mented in three provinces of Argentina: the Autonomous
City of Buenos Aires, Buenos Aires Province and Santa Fe
Province. UNODC also supported Argentina in the drafting
of a code of good conduct for chemical precursors opera-
tors, which constitutes a useful tool for promoting the joint
control of chemical precursors in the public and the private
sectors. The code highlights the importance of consensus
between both sectors with respect to good practices in the
use of chemical precursors to prevent their diversion to
illicit markets.
641. Between March and July 2023, UNODC con-
ducted several technical workshops and training sessions
to increase the capacity of police officers, prosecutors and
judges at the national and subnational levels in Argentina
in the following areas:
(a)
identifying illicit mechanisms for
obtaining chemical substances and precursors by organized
crime;
(b) the
strategic criminal investigation and prosecu-
tion of drug trafficking cases and associated corruption;
(c)
the production of narcotic drugs (including synthetic
drugs and new psychoactive substances) and the chemical
substances and precursors used for their illicit manufacture;
(d)
the introduction to synthetic drugs, synthetic opioids
and chemical substances in the illicit production of drugs;
and
(e)
the inspection and safe handling, transportation and
temporary storage of chemicals and precursors.
642. On 18 April 2023 an Early Warning System for New
Psychoactive Substances was created by joint resolution No.
1/2023 of the Argentine Ministry of Security, the Ministry
of Science, Technology and Innovation and the Secretariat
for Comprehensive Drug Policies (SEDRONAR). The Early
Warning System collects, produces, systematizes and com-
municates reliable information on new psychoactive sub-
stances, emerging drugs and new modalities of consumption
and commercialization in Argentine territory, in order to
prevent and reduce possible negative effects on people
and for public health, on the basis of early detection, risk
assessment, communication and the development of timely
responses.
4. National legislation, policy and
action
638. On 13 December 2022, Ministry of Security of
Argentina approved new “Intervention Guidelines for Police
and Security Forces in situations involving people with
mental health crises and/or problematic consumption in
public space” through resolution No. 843/2022. According
to the guidelines, the ultimate goal of an intervention is risk
reduction until the arrival of health services, preserving the
safety of the people involved and the security forces on the
ground, facilitating access to health and social services.
639. On 8 November 2022, through resolution No.
760/2022, the Ministry of Security of Argentina created
the national precursor chemicals observatory to support
the Implementation Authority of the National Registry
of Chemical Precursors, created by Law No. 26.045. The
observatory will centralize, process, systematize, analyse
and monitor available information on precursor chemicals,
with the goal of strengthening the State’s capacity to pre-
vent and investigate illicit trafficking in precursor chemi-
cals by strengthening the linkages between the various
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643. On 30 December 2022, the Plurinational State of
Bolivia approved the National Plan for Drug Demand
Reduction for the period 2023–2025 through ministerial
resolution No. 0765. The Plan has a community and public
health focus, giving special attention to vulnerable popula-
tions. It includes a plan of action along the following lines:
prevention, treatment, rehabilitation, reintegration and
multisectoral coordination. The institutional actors that
will be involved in the implementation of the Plan are the
Ministry of Health and Sports, the Ministry of Education,
the Ministry of Government, the autonomous departmental
governments and the autonomous municipal governments.
644. On 29 August 2023, the Minister of Interior of the
Plurinational State of Bolivia and UNODC signed an agree-
ment for a project entitled “Support in the fight against
corruption in the Special Force to Fight Drug Trafficking
(FELCN)”. The project will strengthen good governance by
developing risk management, promoting ethics and integrity
and strengthening the capacities of the counter-narcotics
police.
645. In Brazil, SENAD has been restructured by decree No.
11.348, of 1 January 2023. The decree restores the institu-
tion’s mandate as related to drug demand and prevention and
creates a General Coordination of Special Projects on Drugs
and Racial Justice. SENAD is divided into three directorates:
prevention and social reintegration; research, evaluation and
information management; and asset management and justice.
On 6 April 2023, SENAD restructured the National Council
for Drug Policy through presidential decree No. 11.480. The
main changes refer to the establishment of social participa-
tion, with an equal composition between representatives of
the Federal Government and civil society, and the introduc-
tion of an electoral process. SENAD plans to carry out its
activities through five cross-cutting strategic pillars, with a
special focus on vulnerable groups:
(a)
the national strat-
egy for access to rights for women in drug policy;
(b) the
strategy for mitigation and reparation of the impacts of drug
trafficking on indigenous populations and ethnoterritories;
(c)
the national strategy for racial justice in drug policy;
(d) the
strategy for attention to children and adolescents in
drug policy; and
(e)
the inter-institutional articulation strat-
egy for homeless people in drug policy. The first two strategies
targeting women and Indigenous Peoples have been launched
in 2023 and are under implementation.
646. The Early Warning System on Drugs of Brazil, which
aims to rapidly identify the emergence of new psychoactive
substances through cooperation between different Brazilian
institutions, published three reports in 2022 that presented
data and analysis on new psychoactive substances. In
November 2022, it published its third thematic bulletin on
the diagnosis of forensic chemistry and toxicology labora-
tories of scientific policies in Brazil. The report contained
recommendations, including to establish a minimum
number of experts needed according to the volume and
level of demand for analysis in each laboratory, to provide
continuous training for the experts and to establish parame-
ters for prioritizing equipment purchases. In 2023, the Early
Warning System on Drugs published one report on fentanyl
and one on synthetic cannabinoids. The report on fentanyl
alerts the public to the global threat posed by the substance
and reports modalities of intoxication observed in Brazil, as
victims have unknowingly ingested fentanyl-laced synthetic
cannabinoids and LSD. The report contains recommenda-
tions that naloxone be made available for emergency ser-
vices and that monitoring of the situation be strengthened.
With respect to synthetic cannabinoids, the report shows an
increase in seizures and cases of intoxication, especially in
the south-eastern states of Brazil and recommends further
monitoring by the institutions involved.
647. In September 2023, Colombia launched its National
Drugs Policy for the period 2023–2033. In preparing the
policy, 25 territorial consultations were conducted so that
the policy would include a community perspective. The
policy document contains a diagnosis of the drug prob-
lem in Colombia, including details on the relation between
the National Drugs Policy and the peace agreement with
FARC-EP. Furthermore, one of the policy’s objectives is to
establish a regulatory framework for the adult use of can-
nabis with a focus on human rights, public health, social
and environmental justice.
648.
The Board wishes to draw the attention of all
Governments to the fact that measures permitting the
non-medical use of cannabis are contrary to the provi-
sions of the international drug control conventions, spe-
cifically article 4, paragraph (c), and article 36 of the 1961
Convention as amended, and article 3, paragraph 1 (a),
of the 1988 Convention.
649. On 18 May 2023, Ecuador launched three new secu-
rity strategies: the Emerging Strategy to Prevent and Contain
Criminal Violence 2023–2024, the National Strategy against
Organized Crime 2023–2030 and the Specific Strategy
against International Trafficking in Scheduled Substances
Subject to Control 2023–2030. The latter serves as an
operational instrument of national policy to counter drug
trafficking in a strategic and coordinated manner within the
different public security mechanisms. This strategy seeks not
only to reduce the supply of drugs but also to strengthen
institutional processes of intelligence, investigation and mul-
timodal interdiction, improve international cooperation and
fight corruption, money-laundering and organized crime.
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INCB REPORT 2023
650. On 26 June 2023, the Government of Uruguay
announced a national plan for mental health and addic-
tions. The estimated budget for the plan, which will start
implementation on 1 January 2024, was the equivalent of
$20 million. The plan has two pillars: on prevention and
promotion; and on treatment, inclusion and rehabilitation.
The first pillar, on prevention, incorporates the Integral
Prevention Plan for the period 2021–2025 (“Uruguay pre-
viene”), focusing on social inclusion and preventing use
among adolescents and youth. The second pillar is the
expansion of mental health and drug treatment services of
the National Integrated Health System, including the provi-
sion of psychotherapy and the creation of new drug addic-
tion treatment centres.
651. Regarding the control of precursor chemicals, the
Plurinational State of Bolivia approved two supreme decrees
on 12 April 2023 to strengthen precursor control within the
country and along its boarders. Decree No. 4910 strength-
ens mechanisms for the regulation, control, monitoring
and inspection of the trade in gasoline and diesel. Decree
No. 4911 improves the administrative work of the General
Direction of Controlled Substances, establishes the require-
ments and procedure for licit activities involving controlled
chemical substances and strengthens mechanisms of moni-
toring. The Government has also prepared draft legislation
to modify law No. 913, including in its list V eight new
substances to be controlled as precursor chemicals: sodium
permanganate, sodium metabisulfite, sodium bisulfite, jet
fuel, ethyl acetate, butyl acetate, isopropyl alcohol and cal-
cium chloride. This is in addition to the 42 other precursor
chemicals already under control in the country. The draft
legislation is currently being examined by the country’s
Plurinational Legislative Assembly.
the Peruvian Amazon. The most significant increase in illicit
cultivation from 2021 to 2022 occurred in the departments
of Ucayali (from 10,151 ha to 14,531 ha), Loreto (from
10,348 ha to 13,844 ha) Cusco (from 13,642 ha to 16,009 ha)
and Junín (from 6,701 ha to 8,063 ha). The valley of the
Apurímac, Ene and Mantaro rivers continued to account
for the largest share of the illicit cultivation in 2022: 37.6 per
cent. From another perspective, 19 per cent (18,076 ha) of
the total area of cultivation was in territories of Indigenous
or original communities and 16 per cent (14,865 ha) in
natural protected areas and bordering areas. The country
also reported increased levels of crop eradication, reaching
21,628 ha in 2022. Although the area of eradicated crop cul-
tivation is still below the amounts achieved in 2018 and 2019
(25,107 ha and 25,565 ha, respectively), it is well above the
amounts reported for 2020 and 2021 (6,237 ha and 5,557 ha,
respectively).
654. The Government of the Plurinational State of Bolivia
reported to the Board that, from 2021 to June 2023, the
country implemented 24,961 interdiction operations,
resulting in the seizure of 52 tons of cocaine, 515 tons of
cannabis herb, 1,643 tons of solid chemicals, 1,753 litres of
liquid chemicals and 837 tons of coca leaf, as well as the
destruction of 135 crystallization and recycling laboratories
and 1,737 factories. The operations have led to the arrest of
8,193 people. The Plurinational State of Bolivia also reported
the eradication of 24,537 ha of surplus coca crops from 2021
to July 2023.
655. On 28 February 2023, the Bolivian Minister of
Government and UNODC presented the main findings of
the report on the validation of information on the destruc-
tion of illegal drugs seized in 2022 in the Plurinational State
of Bolivia. The projected goal of 80 per cent annual vali-
dation has been surpassed, reaching 87 per cent. In 2022,
counter-narcotics police seized and destroyed 19.3 tons of
cocaine and 11.1 tons of cannabis. UNODC participated
in 88.5 per cent of cocaine destruction (17.1 tons), 84 per
cent of marijuana destruction (9.4 tons) and final disposal
of 17,489 MDMA tablets, 645 grams of MDMA in bulk and
527 doses of LSD.
656. During the reporting period, UNODC released its
2022 coca cultivation survey for the Plurinational State of
Bolivia. The document reported a decrease of 2 per cent
in the area under illicit cultivation in the country, from
30,500 ha in 2021 to 29,900 ha in 2022. Out of the total area
cultivated, 61 per cent was concentrated in the Los Yungas
de La Paz region; 38 per cent in Cochabamba; and 1 per cent
in Norte de La Paz. Furthermore, UNODC also reported
seizures of 331 tons of coca leaves in the Plurinational
State of Bolivia for 2022, a 12 per cent increase in relation
to 2021. The report estimated a potential production of coca
5.
Cultivation, production,
manufacture and trafficking
652. Coca bush, cocaine and cannabis continue to be the
main controlled crops and substances to be illicitly cul-
tivated, produced or manufactured and trafficked in and
from South America. Coca leaves are illicitly cultivated
mostly in Colombia and Peru, and to some extent in the
Plurinational State of Bolivia, while cannabis is illicitly
grown in several countries in the region, including Brazil,
Chile and Paraguay. The diversification of some traditional
drug trafficking routes and modalities has been observed,
including in the Amazon region, which may be linked to
recent restrictions related to the COVID-19 pandemic.
653. In June 2023, Peru reported a record level of 95,008
ha of illicit coca bush cultivation in 2022, an 18 per cent
increase from 2021 and which took place most notably in
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
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leaves of between 44,400 and 55,700 tons, with an estimated
value between $229 million and $279 million. Furthermore,
coca paste seizures decreased 15 per cent from the previous
year, to 10.13 tons in 2022, while cocaine seizures increased
31 per cent to 10.21 tons.
657. In September 2023, UNODC in cooperation with the
Government of Colombia published its annual report on
coca cultivation. For a second consecutive year, Colombia
saw a record high in the area of illicit coca cultivation, with
an expansion by 13 per cent to 230,000 ha (in parallel with
a decline of 33 per cent in the areas eradicated, falling to
69,000 ha) and an increase of 24 per cent in the potential
quantity of cocaine manufactured, reaching 1,738 tons,
which is the highest level for that metric ever reported for
the country. The area of illicit cultivation rose, compared
with 2021, by 21.5 per cent in national natural parks, 18 per
cent in Indigenous protected territories, 4 per cent in land
of black communities and 2 per cent in forest reserves. In
parallel, between 2021 and 2022, the number of dismantled
laboratories fell by 18 per cent to 4,707. Cocaine seizures
and manual eradication have also decreased since 2021, by
1.5 per cent and 33 per cent, respectively.
658. The largest increases in the area under coca cultivation in
Colombia in 2022 were reported from the Putumayo-Caquetá
region (88 per cent), located in the south of the country, close to
the border with Ecuador. Of concern was that 50 per cent of the
increase is within 10 km of the border. Meanwhile, the report
shows an increase in drugs seizures in Ecuador, to 201 tons in
2021, 90 per cent of which was cocaine, from 128 tons in 2020
and 82 tons in 2019. Other border areas with high concentra-
tion of illicit coca cultivation include Nariño, at the border with
Ecuador, Norte de Santander, at the border with the Bolivarian
Republic of Venezuela and, to a lesser extent, Chocó, at the
border with Panama.
659. Peru previously worked with UNODC to conduct
periodic surveys of the area of illicit crop cultivation and
area of illicit crop eradication. The country issued joint crop
monitoring reports with UNODC from 2002 to 2018, and
from 2019 to 2022 the country has produced data on illicit
crops independently. UNODC is currently working with the
Government of Peru and technical experts with a view to
issuing a joint report in 2024 on the basis of data for 2023.
660.
The Board reiterates its recommendation that Peru
resumes the studies and monitoring reports on territories
affected by illicit crops that are prepared in cooperation
with and fully certified by UNODC. This, in addition to
ensuring support for the efforts of the Government of Peru
in the fight against drug trafficking, will allow adequate
comparative monitoring among the three Andean countries
most affected by illicit crops. Moreover, reports certified by
UNODC will introduce stronger, evidence-based data to
enable the development of more effective crop reduction
strategies. In this connection, the Board notes with appre-
ciation the surveys undertaken by Bolivia (Plurinational
State of) and Colombia with UNODC support.
661. While cannabis herb seizures decreased in the region
in 2021, largely due to decreases in Brazil and Paraguay,
according to the OAS/CICAD
Report on Drug Supply in the
Americas 2022,
transnational cannabis trafficking in South
and Central America is on the rise. This trend could reflect
increased trafficking of cannabis from regional produc-
ers, more effective interdiction by the security forces and/
or a greater focus by law enforcement agencies on canna-
bis. CICAD highlighted that several countries reported an
increased prevalence of a more potent strain of cannabis
originating in Colombia called “creepy”. The presence of this
strain in domestic markets was reported by Chile and Peru
to the extent that, in some cases, it displaced the longstand-
ing domination of cannabis from Paraguay. According to
the report, Guyana also noted the appearance of “poppy”,
another name for “creepy”, from the Bolivarian Republic of
Venezuela, which became popular in the local market. The
presence of “creepy” in other parts of the Caribbean was also
reported by the Bahamas.
662. In the annual report of the Drugs Early Warning
System of Uruguay, issued in July 2023, the National Drug
Board reported the issuance of two alerts in 2022. The first,
issued in August 2022, related to “pink cocaine”, “tuci” or
“tucibi”, and its dangerous composition which includes the
combination of ketamine with different psychoactive sub-
stances. In an emblematic case, the Drugs Early Warning
System was notified of a drug sample that included keta-
mine, methamphetamine, MDMA, tramadol and caffeine.
“Pink cocaine” was first detected in Uruguay in 2020, and
its presence in the country has increased since then. The
second alert was issued in November 2022 on the dangers
of ingesting pills with an “EA Sport” logo. Based on reports
from the Toxicology Information and Support Centre
(CIAT), the analysis of the laboratory of the Technical
Forensic Institute identified 74 mg of MDA in the pills.
MDA is tenamphetamine, a psychoactive substance of the
phenylethylamine family, derived from amphetamine and
is an analogue of MDMA (“ecstasy”), and produces similar
effects in the body.
663. In Uruguay, the most seized drug continues to
be cannabis, which made up 38.2 per cent of the total of
drug seizures in 2022. Cannabis was followed by cocaine
base paste (36.1 per cent) and cocaine (16.8 per cent) for
that year. Synthetic drugs accounted for the fourth high-
est amount of seizures, at 3 per cent. Although percentage
shares of the total varied throughout the years, this ranking
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INCB REPORT 2023
of most seized drugs by number of seizures has remained
constant since 2018. However, the percentage related to
cannabis has been decreasing (from 47.5 per cent in 2018),
while the percentage of cocaine base paste has been increas-
ing (from 26.6 per cent in 2018). Moreover, the number of
seizures of synthetic drugs has had the sharpest increase,
from 62 in 2018 to 169 in 2022, followed by cocaine base
paste, from 789 in 2018 to 2,056 in 2022. The most seized
synthetic drugs in 2022 were MDA, MDMA, methampheta-
mine, 2C-B-NBOH (25B-NBOH), LSD, “pink cocaine” and
ketamine, by number of seizures.
664. In the Bolivarian Republic of Venezuela, the most
seized drug in 2022 was cocaine, at 32.67 tons, followed
by cannabis, at 14.54 tons. Most drug seizures took place
in the states of Apure, Bolívar, Falcón and Zulia. Of 8,223
operations, the largest number of operations were linked
to cannabis herb seizures (6,379), followed by cocaine and
derivatives (1,636), ketamine (11), heroin (8), “ecstasy” (8),
“poppers” (4), amphetamines and methamphetamines (3),
alprazolam (2) and LSD (1). Security forces destroyed 58
crystallization laboratories close to the western border
with Colombia, neutralized 45 aircrafts and destroyed 57
illegal air strips. The Bolivarian Republic of Venezuela also
reported the eradication of 40 ha of illicit coca bush culti-
vation along the border with Colombia in 2022. The main
countries of destination for seized drugs were the United
States, Spain, Australia, Guinea, Netherlands (Kingdom of
the), Italy and South Africa, in order of significance. In 2022,
the country recovered 341 vehicles, 25 boats, 44 buildings,
two aircraft and 437 miscellaneous objects.
665. The Bolivarian Republic of Venezuela reported the
implementation of joint counter-narcotics operations with
law enforcement officials of France in Caribbean inter-
national waters. On 11 December 2022, an operation in
Martinique interdicted a vessel containing 1.5 tons of can-
nabis, leading to the arrest of 11 Venezuelan citizens. On
25 January 2023, another Venezuelan vessel was intercepted
in the same area, resulting in the seizure of 324 kg of can-
nabis and the arrest of 10 Venezuelans and 1 Colombian.
On 6 March 2023, this collaboration led to the interception
of a vessel 250 miles east of Barbados, with the seizure of
1.8 tons of cocaine and the arrest of 8 Venezuelan citizens.
667. Ecuador is implementing a project for the develop-
ment of a strategy for a comprehensive approach to the
socioeconomic phenomenon of drugs and the strengthen-
ing of mental health for the period 2022–2025. The follow-
ing surveys and studies are planned as part of that project:
a national survey on drug use and mental health problems
(2023–2024); a national survey on drug use and consump-
tion among students of ninth year of basic education and
first and third year of baccalaureate (2024); a survey on use
and consumption among university students (2024); research
in treatment centres (2023–2024); 24 provincial situational
diagnoses (2024–2025); and research on violence associ-
ated with drug use or sales (2024). The most recent official
national surveys of drug use among the general population
date from 2016, those surveys on use among people in higher
education date from 2015, and 2014 for those in secondary
education. Official national surveys on treatment issues will
be carried out for the first time in the country. The Ministry
of Public Health of Ecuador registered 70,062 visits for
mental and behavioural disorders due to the consumption
of psychoactive substances classified according to ICD10
(F10–F19) during 2022.
The Board welcomes the efforts of
Ecuador in the implementation of surveys and data collec-
tion in the area of mental health, drug use and treatment.
668. The Bolivarian Republic of Venezuela reported pre-
liminary results of its national drug survey entitled “Study
of perception, risk, consumption and ease of access to drugs
2022”. The survey was conducted in 2022 and interviewed
12,160 persons between 12 and 65 years old. Cannabis herb
was the most consumed controlled substance among the
population, with a past-year prevalence of 1.41 per cent,
followed by cocaine (0.82 per cent) and “crack” cocaine
(0.72 per cent). Similarly, the statistical bulletin from
the National Public System for Addiction Attention and
Treatment reported that out of the 2,382 persons who
received treatment for drug dependence in 2022, 89.3 per
cent consumed cannabis herb, 1.6 per cent consumed
“crack” cocaine, and 0.6 per cent consumed cocaine.
669. The Bolivarian Republic of Venezuela reported 9,631
drug prevention activities in the first half of 2023, provid-
ing support to 1,094,325 beneficiaries. The country also
implemented the “Safe school” programme in primary and
secondary level educational centres, in order to expose and
address, from a preventive and awareness-raising approach,
the risks of drug use and micro-trafficking. This initiative
has been relaunched together with the “School for parents”
programme, based on co-responsibility in the care and
supervision of their children in the face of the risks of drug
use and crime.
670. In 2023, UNODC supported the national seminar
on prevention research held by SENAD in Brazil, at which
6. Prevention and treatment
666. According to the latest data published by UNODC,
cannabis has the highest regional past-year prevalence
in South America (3.58 per cent), followed by cocaine
(1.62 per  cent), amphetamines and prescription stimulants
(0.88 per cent), opioids (opiates and prescription opioids)
(0.30 per cent), and “ecstasy” (0.24 per cent).
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was launched the virtual platform of the project to support
the implementation of the national system for prevention
of alcohol and other drug use. The event aimed to promote
prevention strategies in Brazil and had the participation of
government representatives as well as researchers in the pre-
vention area. The project is a partnership between SENAD,
UNDP and UNODC. It seeks to integrate a comprehensive
set of interventions and evidence-based strategies to sys-
tematize, at the national, state, and municipal levels, access
to information, initiatives in prevention and management of
policies, actions and to strengthen programmes to prevent
the use of alcohol and other drugs.
671. In July 2023, Chile launched the first activities for the
establishment of a social innovation laboratory to tackle the
issue of drug use among minors under the custody of the
State. The initiative is supported by COPOLAD programme
and the Agirre Lehendakaria Centre, a social innovation
laboratory associated with the University of the Basque
Country. Authorities and institutions such as the Ministry
of Health, the National Specialized Protection Service for
Children and Adolescents and UNICEF participated in the
initiative, together with relevant community groups.
672.
The Board wishes to encourage Member States
to improve the collection of data on drug use patterns
and, whenever possible, to implement periodic drug use
surveys.
Illicit manufacture of and trafficking in ketamine, a sub-
stance not under international control, continues to be an
issue of concern in the region. Seizures of ketamine nearly
tripled in 2022 compared with 2021, and there has been a
proliferation of clandestine laboratories for the illicit manu-
facture of the substance.
1.
Major developments
673. The epicentre for the illicit production of opium
and manufacture of methamphetamine and, increasingly,
of ketamine in the region remains Shan State in Myanmar,
owing to continued political instability in the country. The
illicit cultivation of opium poppy and trafficking in opium is
also centred in Shan State. Between 2021 and 2022, the cul-
tivation of opium poppy in the country rose by 33 per cent
and the production of opium by 88 per cent. Approximately
790 tons of opium were estimated to have been produced
in 2022 in Myanmar.
674. Seizures of methamphetamine in Myanmar totalled
38.9 tons in 2022, up 22 per cent from the year before.
Countries in the region as well as in neighbouring regions
of South Asia and Oceania report that most seized meth-
amphetamine originates in Myanmar. As is the case with
opium, methamphetamine is trafficked across East and
South-East Asia and continues to pose a major challenge
for countries in the region.
675. In June 2023, Malaysia amended part of its penal
code and drug control legislation formally removing man-
datory death sentences for various criminal offences, includ-
ing drug-related offences. Transitional measures were also
introduced to allow the country’s courts to review existing
death penalty sentences and possibly commute them to life
imprisonment.
676. The prevalence of drug use in East and South-East
Asia has remained significant. The most used drug in 2021
was cannabis. Methamphetamine and other amphetamine-
type substances, which are heavily trafficked in the region,
were the second most used group of substances. There is also
an established market for the non-medical use of ketamine
in the region.
677. Several countries and territories in the region have
introduced regulatory changes related to the scheduling and
use of cannabis. Hong Kong, China, included CBD under
the strictest levels of control in the territory, with trafficking
in and the illicit manufacture, possession and consumption
of CBD being liable to severe prison sentences, including life
imprisonment, and high monetary fines. The Lao People’s
Democratic Republic has regulated the cultivation and use
D. Asia
East and South-East Asia
The illicit cultivation of opium poppy and manufacture of
methamphetamine are among the most significant drug
challenges facing East and South-East Asia.
The prevalence of drug use in East and South-East Asia has
remained significant, with cannabis being the most used
drug, followed by methamphetamine and other ampheta-
mine-type substances.
Several countries and territories in the region have intro-
duced regulatory changes related to cannabis.
malaysia formally removed mandatory death sentences and
life imprisonment for drug-related offences.
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INCB REPORT 2023
of cannabis for medical purposes, with a licensing scheme
for medical products containing CBD with not more than
1 per cent THC by weight or 0.2 per cent for raw and pro-
cessed products, and for the registered sale of cosmetics,
beverages and aromatic oils containing CBD.
rapid communication on emerging global and regional
drug-related threats.
681. In July 2023, law enforcement and regulatory authori-
ties of Malaysia and the Philippines participated in bilateral
meetings with UNODC to coordinate improvements in pre-
cursor control, share information and discuss methods to
disrupt the trafficking of precursor chemicals used for the
illicit manufacture of synthetic drugs. While authorities in
the region have pointed to the growing use of non-controlled
chemicals in illicit drug production, it was noted that the
current understanding of many of these substances remains
limited. The discussions with Malaysia focused on sharing
information regarding regulatory updates and the evolution
of substances being leveraged by organized criminal groups
in the region together with the latest trafficking trends, while
the discussions with the Philippines focused primarily on
domestic precursor control challenges relating to inter-
agency coordination as well as the growing importance of
strengthening both regional and inter-agency collaboration.
682. In July 2023, Myanmar hosted the 44th ASEAN
Senior Officials Meeting on Drug Matters, which also
included participants from China, India, the Republic of
Korea and the Russian Federation as well as UNODC. The
Meeting’s five working groups on preventive education,
treatment and rehabilitation, law enforcement, research and
alternative development also met. The meetings focused on
the preparation of an ASEAN ministerial meeting on drugs
and other international forums on drug policy to be held
in the future.
683. A total of 168 drug control officials from the compe-
tent national authorities of 15 countries in East and South-
East Asia, namely, Brunei Darussalam, Cambodia, China,
Indonesia, Japan, the Lao People’s Democratic Republic,
Malaysia, Mongolia, Myanmar, the Philippines, the Republic
of Korea, Singapore, Thailand, Timor-Leste and Viet Nam,
have registered to use INCB Learning e-modules. INCB
Learning has developed five e-learning modules that cover
regulatory and policy issues related to narcotic drugs, psy-
chotropic substances, precursor chemicals, the international
drug control framework and ensuring the adequate avail-
ability of controlled substances for medical and scientific
purposes. The modules are available at no cost to officials
of competent national authorities by contacting INCB
Learning.
684. During the reporting period, the INCB GRIDS
Programme engaged in an extensive number of workshops,
seminars and other capacity-building activities for countries
in East and South-East Asia in order to address the prolifera-
tion of and trafficking in new psychoactive substances and
other non-controlled substances.
2.
Regional cooperation
678. Indonesia established an early warning system for
synthetic drugs, which currently does not exist anywhere in
South-East Asia, and Malaysia and Thailand are in the pro-
cess of establishing a similar system. National-level consulta-
tive dialogues were held in each country, with the support
of UNODC, from December 2022 through March 2023.
These dialogues brought together experts from the forensic,
health, law enforcement, regulatory and academic sectors to
discuss the necessary initial steps for creating early warning
systems for synthetic drugs in their respective countries. In
September 2023, UNODC organized a national consulta-
tive dialogue on early warning systems with the Philippines,
which is also in the process of establishing such a system.
679. In September 2023, ministers and senior officials
from Cambodia, China, the Lao People’s Democratic
Republic, Myanmar, Thailand and Viet Nam and from
UNODC gathered in Beijing for the 14th Ministerial
Meeting of the Mekong Memorandum of Understanding on
Drug Control. This year’s Ministerial Meeting endorsed the
Beijing Declaration, which recognizes the extent of the drug
challenges in the Mekong area and supported a regional
action plan outlining practical actions that countries and
the United Nations would take to address the drug problem.
The Ministerial Meeting was followed by a meeting of its
Senior Officials Committee. The senior officials agreed on a
new plan of action that envisages greater focus on strength-
ening prevention and treatment initiatives, enhancing law
enforcement cooperation, strengthening international
judicial cooperation and promoting sustainable alternative
development programmes.
680. To respond to the ongoing challenges and the evolu-
tion of the regional synthetic drug market, the UNODC
SMART programme held a regional meeting in August
2023 that gathered law enforcement, public health and drug
forensics experts from member States of the Association of
Southeast Asian Nations (ASEAN) and East Asia, includ-
ing China, Japan and the Republic of Korea, as well as the
WCO Regional Intelligence Liaison Office for Asia and the
Pacific. Participants shared the latest developments and
discussed strategies to address the drug situation in the
region. The Programme will provide science-led capacity-
building in such areas as drug detection, analysis, early
warning and chemical disposal, as well as enable more
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685. From 7 to 11 November 2022, the INCB GRIDS
Programme carried out a second twinning mission in South-
East Asia for 15 front-line officers from customs and regula-
tory agencies in the Lao People’s Democratic Republic and
Viet Nam. The event developed networking, communication
and practical skills for international operational coopera-
tion in conjunction with capacity-building workshops to
increase use of the Board’s IONICS secure communication
platform and the INCB GRIDS Programme. Officers also
received practical training from the INCB GRIDS Regional
Technical Officer for East and South-East Asia and the
Pacific in opioids identification, safe handling and inter-
diction approaches using personal protective equipment
and presumptive field testing for opioids.
686. On 15 and 16 November 2022, the INCB GRIDS
Programme organized a training event to raise aware-
ness and develop communication capacity utilizing INCB
IONICS and INCB GRIDS targeting tools in Vung Tau,
Viet Nam, for 19 officers from the Counter-Narcotics Police
Department and the Anti-smuggling and Investigations
Customs Department.
687. The INCB GRIDS Programme conducted an
interregional workshop on public-private partnerships
between Governments and logistics companies operat-
ing in Afghanistan and neighbouring countries from 28
to 30 November 2022. The workshop was held in Istanbul,
Türkiye, and brought together 42 participants; it built upon
the success of previous meetings held by INCB since 2018
related to the prevention and misuse of logistics services for
trafficking in dangerous substances and promoting coopera-
tion between Governments and logistics companies.
688. On 6 and 7 December 2022, two case meetings
between the Narcotics Control Department of Japan and
the Counter-Narcotics Police Department and General
Department of Viet Nam Customs were organized by
the INCB GRIDS Programme to discuss cases related to
trafficking in ketamine, new psychoactive substances and
synthetic opioids following the arrest of traffickers from
Viet Nam in Japan.
689. From December 2022 to January 2023, China,
Indonesia, Japan, the Lao People’s Democratic Republic, the
Philippines, Singapore, Thailand and Viet Nam participated
in the Board’s Operation Knockout. The operation focused
on the exchange of intelligence to identify and dismantle
illicit manufacturing and distribution points involving
non-medical carisoprodol, 1,4-butanediol, flubromazepam,
gamma-butyrolactone
and ketamine trafficked through
the international post, express mail, courier services and
related modalities.
690. The INCB GRIDS Programme organized an online
stakeholder consultation on voluntary cooperation between
Governments and freight forwarding services for the pre-
vention of trafficking in dangerous substances from 21 to
23  February 2023. The event was attended by 44 rep-
resentatives from 10 Governments, three international
organizations and six industry associations, including
five participants from China and Singapore. Participants
exchanged best practices and shared examples related to
the exploitation of legitimate ancillary logistics services and
discussed the next steps for promoting voluntary coop-
eration between Governments and their private sector
partners.
691. In March 2023, the INCB GRIDS Programme con-
ducted a series of training events in Cambodia, Indonesia,
Malaysia and neighbouring countries for 85 officers from
drug law enforcement and regulatory agencies from each
country. The training aimed to enhance reporting and
interdiction activities across South-East Asia to address the
growing global challenge posed by synthetic drugs using
INCB intelligence tools, such as IONICS and INCB GRIDS
Intelligence high-definition targeting tools. Participants also
received practical instruction on opioids identification in
the field, safe handling and interdiction approaches using
personal protective equipment and presumptive field test-
ing for opioids.
692. In May 2023, the INCB GRIDS Programme organ-
ized two train-the-trainer workshops for 30 officers from
the Viet Nam Customs School, the People’s Police Academy
and the Counter-Narcotics Police Department. The training
focused on utilization of the INCB GRIDS Programme’s
IONICS platform and INCB GRIDS Intelligence high-
definition targeting tools, awareness-raising and safe inter-
diction approaches for synthetic opioids, fentanyl-related
substances and new psychoactive substances.
693. On 23 May 2023, the INCB GRIDS Programme con-
vened a national expert group meeting in Bangkok on ways
for freight forwarders and third-party logistics providers to
prevent trafficking in dangerous non-scheduled substances.
Stakeholders discussed current regional trafficking trends
alongside challenges confronting logistics providers and
exchanged promising practices to prevent future exploita-
tion by traffickers. Thirty representatives from government
agencies, international organizations and private sector
companies participated in the event.
694. On 24 May 2023, the INCB GRIDS Programme
hosted a training event for 20 law enforcement officers from
Thailand. The training focused on enhancing knowledge
and skills to identify and safely interdict dangerous sub-
stances. Participants also received instruction on the use
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INCB REPORT 2023
of the IONICS platform and INCB GRIDS Intelligence
high-definition targeting tools to improve cross-border
intelligence-sharing.
695. From 12 to 15 June 2023, the INCB GRIDS Programme
organized a joint twinning event between the West Africa
and the South-East Asia regions in Lagos, Nigeria, for
13  drug law enforcement and regulatory officers from
Ghana, Nigeria, Thailand and Viet Nam. The event provided
an opportunity to further enhance participants’ capacity
to use the INCB IONICS platform and the INCB GRIDS
Intelligence tools and to develop networks and skills for
international operational cooperation related to new
psychoactive substances and non-medical synthetic opioids.
696. On 25 and 26 July 2023, the INCB GRIDS Programme
hosted a national training event in Da Nang, Viet Nam, for
21 customs officers. This event included awareness-building
on opioids, fentanyl substances and new psychoactive sub-
stances as well as safe interdiction modules. Additionally,
training was conducted on basic targeting and intelligence-
gathering using the IONICS and INCB GRIDS Intelligence
high-definition platforms to enhance counter-trafficking
efforts in the region.
697. On 1 and 2 August 2023, the INCB GRIDS Programme
organized a national-level workshop in Ho Chi Minh City,
Viet Nam, on public-private partnerships for the prevention
of trafficking in dangerous substances through express cou-
rier, mail and postal services. Participants discussed current
trends and challenges that they were facing to protect their
areas of operation from being exploited by traffickers. More
than 25 representatives from Government agencies, inter-
national organizations and the private sector participated
in the event.
698. The INCB GRIDS Programme organized the sixth
annual operational meeting on countering trafficking in
dangerous synthetic drugs and chemicals through postal,
courier and air cargo services, held in Vienna from 11 to 15
September 2023. The event brought together over 100 offic-
ers from over 30 Governments, private sector partners and
international and regional organizations, including from
China, Indonesia, Singapore, Thailand and Viet Nam.
699. The INCB GRIDS Programme convened the third
international expert group meeting on expanding INCB
lists of dangerous substances with no known legitimate use
and novel approaches for their identification in falsified or
illicitly manufactured pharmaceuticals, held in Vienna from
18 to 22 September 2023. The event brought together over
40 representatives from over 20 Governments and inter-
national organizations, and the private sectors, including
from China, Singapore and Thailand. Participants discussed
the latest intelligence on dangerous substances with no
known legitimate use, and demonstrated state-of-the-art
approaches for the rapid detection of suspicious packaging
and falsified and illicitly manufactured pharmaceuticals.
700. From 30 October to 3 November 2023, the INCB
GRIDS Programme organized two training events for
30 officers from the Lao People’s Democratic Republic. These
events included modules on awareness and safe interdiction
of opioids, fentanyl and new psychoactive substances as well
as basic targeting and intelligence training using the INCB
IONICS and INCB GRIDS Intelligence high-definition plat-
forms to enhance counter-trafficking in the region.
3.
Availability of internationally
controlled substances (including
reporting to the Board)
701. The three international drug control treaties require
the States parties to furnish statistical reports to the Board
on an annual basis and in some cases on a quarterly basis.
These reports enable the Board to monitor licit activity
involving internationally controlled substances as well as
ensure the availability of these substances for licit medical
and scientific purposes. Among the countries and territo-
ries of East and South-East Asia, reporting performance
has generally been fully compliant for the narcotic drugs
controlled under the 1961 Single Convention, as amended,
and the psychotropic substances controlled under the 1971
Convention, and most countries and territories provided the
required reports for the last five years. A few countries have
not provided any of the required reports for narcotic drugs
and psychotropic substances in the last five years.
702.
The Board encourages the countries and territories
of East and South-East Asia that have not provided the
reports as required under the international drug control
conventions to do so as soon as possible and to take the
necessary measures to ensure that their respective com-
petent national authorities have sufficient resources to
prepare the reports in a timely manner. In this regard,
INCB offers the possibility of training, including through
its INCB Learning programme, to support capacity-
building in the area of reporting.
703. East and South-East Asia is among the regions that
are of particular concern with regard to ensuring and moni-
toring the availability of narcotic drugs and psychotropic
substances for medical and scientific purposes. In particular,
on the basis of the reported consumption of narcotic drugs,
the region is among those with the lowest availability of the
most widely used opioid analgesics.
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
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704. In 2002, East and South-East Asia countries reported
a total consumption of opioid analgesics of 1,281 S-DDD per
million inhabitants. Twenty years later, in 2021, the region
reported consumption at 5,281 S-DDD
pm
, with a peak
of 6,225 S-DDD
pm
being reported in 2017. The Republic
of Korea reported the highest level (1,976 S-DDD
pm
) in
the region, followed by Japan (892 S-DDD
pm
), Brunei
Darussalam (432 S-DDD
pm
) and Singapore (419 S-DDD
pm
).
The rest of the countries in the region reported consump-
tion below 300 S-DDD
pm
. Fentanyl was the dominant
opioid consumed (3,738 S-DDD
pm
), followed by morphine
(670 S-DDD
pm
) and oxycodone (600 S-DDD
pm
).
705. Determining the levels of consumption of psycho-
tropic substances in East and South-East Asia remains chal-
lenging because fewer than half of the region’s countries
and territories have provided the Board with consumption
data on any psychotropic substance for the past five years.
The Board will continue monitoring the situation in this
area and communicating to Governments the importance
of furnishing data on psychotropic substances.
706.
The Board stresses its concern that there is insuffi-
cient availability of narcotic drugs and psychotropic sub-
stances in many countries of the region and emphasizes
the importance of ensuring sufficient availability of and
access to internationally controlled substances for medi-
cal purposes.
707. As regards precursor chemicals, Member States vol-
untarily provide – in the context of resolution 49/3 of the
Commission on Narcotic Drugs – their estimates of their
annual legitimate requirements for imports of certain pre-
cursor chemicals frequently used in the illicit manufacture
of amphetamine-type stimulants. Among other substances,
the estimated annual legitimate requirement is requested for
ephedrine and pseudoephedrine, substances that also have
medicinal uses, as well as, to the extent possible, for prepara-
tions containing those substances that could be easily used
or recovered by readily applicable means.
708. As at 1 November 2023, all countries in the East and
South-East Asia region had provided the Board with at least
one estimate of their annual legitimate requirements for
imports of ephedrine, pseudoephedrine or their prepara-
tions, and they had regularly updated their estimates for
those substances, which contributes to preventing their
oversupply and diversion into illicit channels and ensuring
their availability for legitimate purposes. Two countries in
East and South-East Asia, Timor-Leste and Viet Nam, have
provided annual legitimate requirements to the Board for
the first time in the last five years.
709. Further information on the availability of inter-
nationally controlled substances can be found in the tech-
nical reports of the Board for 2023 on narcotic drugs,
psychotropic substances and the implementation of article
12 of the 1988 Convention. In addition, the publication
entitled
Guide on Estimating Requirements for Substances
under International Control,
developed by INCB and WHO
for use by competent national authorities, and the docu-
ment entitled “Issues that Governments may consider when
determining annual legitimate requirements for imports
of ephedrine and pseudoephedrine” are available on the
Board’s website.
4. National legislation, policy and
action
710. In December 2022, the Lao People’s Democratic
Republic amended its legislation to permit the cultivation
of cannabis for medical purposes and regulations have been
established to authorize persons and businesses to engage
in those activities. The country also put into place a licens-
ing system for medical products containing CBD with not
more than 1 per cent THC by weight or 0.2 per cent for raw
and processed products. Additionally, the sale of cosmet-
ics, beverages and aromatic oils that contain CBD and are
registered with the Laotian Food and Drug Department is
permitted in the country.
711. In January 2023, Hong Kong, China, included CBD
in Schedule I of its Dangerous Drugs Ordinance, which
places the substance under the strictest levels of control
in the territory. According to the Narcotics Division of
the Hong Kong, China, Security Bureau, trafficking in and
illicit manufacture of CBD and related products are liable
to a maximum sentence of life imprisonment and a fine the
equivalent of $640,000. Possession and consumption of CBD
is subject to a maximum penalty of seven years in prison
and a fine the equivalent of $125,000.
712. On 26 January 2023, Pre-Trial Chamber I of the
International Criminal Court granted the request of the
Court’s Prosecutor to resume the investigation of alleged
crimes against humanity on the territory of the Philippines
between 1 November 2011 and 16 March 2019 in the con-
text of the so-called “war on drugs” of the Government of
the Philippines. The Government of the Philippines had
earlier requested a deferral on the grounds that national
authorities were investigating the alleged murders being
investigated by the Court. According to the Chamber, the
permission to resume the investigation was given because
it had concluded that the various domestic initiatives and
proceedings relied on by the Philippines did not amount to
tangible, concrete and progressive investigative steps being
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INCB REPORT 2023
carried out with a view to conducting criminal proceedings
in a way that would sufficiently mirror the Court’s investiga-
tion as authorized in its decision pursuant to article 15 of
the Rome Statute.
713.
The Board reiterates its appeal to Governments to
take all measures necessary to prevent the extrajudicial
targeting of persons suspected of involvement in drug-
related offences. The Board also reiterates in the strongest
possible terms that extrajudicial responses to drug-related
criminality are in violation of the drug control conven-
tions and fundamental human rights, which require
that drug-related crimes be addressed through formal
processes adhering to due process of law. Governments
are called upon to investigate and prosecute all instances
of extrajudicial action purportedly taken in the name of
drug control.
714. In March 2023, the Parliament of Singapore passed
the Misuse of Drugs (Amendment) Bill 2023, and certain
provisions of that law entered into effect in June of that
year. Among those provisions are the introducing of more
stringent penalties, including caning, for the possession of
certain drugs (morphine, diamorphine, opium, cocaine,
cannabis, cannabis resin, cannabis mixture and metham-
phetamine) in quantities above defined weight thresholds.
The bill also introduced a new legislative framework that will
apply as from 2024 whereby substances will be controlled
based on their capacity to produce a psychoactive effect,
rather than their specific chemical formula.
715. According to the 2022 annual report of the Central
Narcotics Bureau of Singapore, of the 2,826 persons arrested
for drug use in 2022, 1,451 had used methamphetamine and
994 had used heroin. A total of 236 persons were arrested for
cannabis use, and there were a few dozen arrests related to
other drugs. The number of users of methamphetamine was
down slightly from the year before, when 1,595 persons had
been arrested for use of the drug. Arrests related to heroin
use were higher in 2022 in comparison with 2021, when
778 persons had been arrested. Cannabis arrests were up
in 2022, from 138 in 2021.
716. In April 2023, the Republic of Korea established a
special investigative unit for drug-related crimes compris-
ing 840 officials, including prosecutors, police and customs
officials. The unit will investigate any drug-related crimes
in the country, with a special focus on Internet-facilitated
drug smuggling and distribution.
717. In June 2023, the Abolition of the Mandatory
Death Penalty Act 2023 and the Revision of the Sentence
of Death and Imprisonment for Natural Life (Temporary
Jurisdiction of the Federal Court) Act 2023 received royal
assent in Malaysia and entered into force in the country. The
Abolition of the Mandatory Death Penalty Act 2023 amends
the country’s penal code and drug legislation by remov-
ing the mandatory death penalty and life imprisonment
for several offences, including drug-related offences. The
Revision of the Sentence of Death and Imprisonment for
Natural Life (Temporary Jurisdiction of the Federal Court)
Act 2023 additionally allows the country’s courts to review
death and life sentences already imposed, including those
for drug-related offences, and instead apply sentences of 20
to 40 years of imprisonment.
718.
The Board notes as a positive development the
legislative changes in Malaysia removing the mandatory
death penalty and life imprisonment for drug-related
offences, and encourages other countries in the region
to follow suit.
719.
While recalling that, according to the international
drug control conventions, the determination of penalties
applicable to drug-related behaviours remains the exclu-
sive prerogative of States parties, the Board encourages
all States that retain the death penalty for drug-related
offences to consider abolishing the death penalty for
drug-related offences and to commute death sentences
that have already been handed down, in view of the rele-
vant international conventions and protocols and relevant
resolutions of the General Assembly, the Economic and
Social Council and other United Nations bodies on the
application of the death penalty for the category of drug-
related offences.
720. In its reporting of annual estimates for narcotic
drugs, Thailand’s competent national authority informed the
Board of policy measures and tools in the country related to
the control of cannabis. Namely, Thailand has introduced
a mobile application for notifications about the cultivation
of cannabis, and a dedicated website, managed by the Food
and Drug Administration. The Ministry of Public Health
provides a cannabis use disorder monitoring programme
through a digital platform, has developed clinical guidelines
for the treatment of cannabis poisoning in the emergency
room, collects and monitors data on drug addiction treat-
ment and rehabilitation including cannabis use, and has
developed a monitoring and reporting system for canna-
bis acute poisoning events. The Ministry also leads public
awareness campaigns and guidelines on the medical use of
cannabis. The Ministry ensures full control and licensing of
cannabis cultivation, trade and imports, except in the case
of what it defines as “herbal products for medical use by
government agencies and for the benefit of clinical studies”,
which are licensed by the Food and Drug Administration.
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
101
721. Earlier, Thailand had also reported that, under the
country’s legislation, CBD is not considered a controlled
substance pursuant to the 1961 Convention as amended or
the 1971 Convention, and its use in non-medical and non-
scientific industries, such as cosmetics and food, will not be
reported to the Board. The Board reiterates that the 1961
Convention as amended limits the cultivation of cannabis,
from which CBD is extracted, to medical and scientific pur-
poses. The Board remains in contact with the authorities of
Thailand on this matter and continues to monitor relevant
developments.
722. China has put into place special measures to ensure
the safe trade of non-controlled and internationally con-
trolled precursor chemicals. The country now issues
special permits for the export of precursor chemicals to
countries it has identified as vulnerable to the illicit manu-
facture of drugs, in particular, Afghanistan, the Lao People’s
Democratic Republic and Myanmar.
725. As with opium poppy, Shan State in Myanmar con-
tinues to be the main source of illicitly manufactured meth-
amphetamine trafficked across East and South-East Asia as
well as Southern Asia and Oceania. Approximately 38.9 tons
of the substance was seized in 2022 in Myanmar, which
was up 22 per cent from the previous year. Approximately
58.4 tons of methamphetamine were seized in Thailand, a
drop of 22 per cent from the previous year. The seizures
were mostly in areas along the border with Myanmar. The
illicit manufacture of methamphetamine, particularly in
Indonesia, has also expanded, with the number of labora-
tories detected in the country increasing from 1 in 2021 to
22 in 2022. Overall seizures of methamphetamine tablets
in East and South-East Asia were down slightly in 2022, at
approximately 900 million from approximately 1 billion in
2021. Similarly, seizures of crystal methamphetamine in the
region stood at approximately 65 tons in 2022, a drop from
approximately 79 tons in 2021.
153
726. According to information published by the Office of
the National Narcotics Control Commission of China in
June 2023, most drugs used in the country originated out-
side the country; illicit domestically produced drugs account
for a small proportion of what is trafficked in the country. In
2022, a total of 11.7 tons of drugs – mainly heroin, metham-
phetamine and ketamine – were seized, which represented a
decrease of 32 per cent from the previous year. Nearly all the
heroin seized (1.29 tons) originated in northern Myanmar,
with only a few dozen kilograms trafficked from other
regions. Similarly, nearly all of the methamphetamine seized
(9.1 tons) originated in northern Myanmar. According to
Chinese authorities, the majority of cannabis seized in
2022 (200.6 kg) originated in North America. The Office of
National Narcotics Control Commission of China further
stated that the diversion of precursor chemicals overall was
on the decline, with 660.2 tons seized in 2022, representing
a decrease of nearly 50 per cent from 2021.
727. In March 2023, Japan made its second-largest single
drug seizure ever in the port of Tokyo, confiscating over
700 kg of methamphetamine powder from a container ship
in a joint operation with Dubai Customs of the United Arab
Emirates.
728. Seizures of ketamine, a substance not under interna-
tional control, rose drastically in 2022, with nearly 27 tons of
the substance having been seized across the region; this was
up sharply from the approximately 10 tons seized in 2021.
The huge increase was driven by seizures in Cambodia of
approximately 13.5 tons, which accounted for 60 per cent
UNODC, Regional Office for South-East Asia and the Pacific,
Synthetic Drugs in East and South-East Asia: Latest Developments and
Challenges
(Bangkok, 2023), map 2.
153
5.
Cultivation, production,
manufacture and trafficking
723. The illicit cultivation of opium poppy, illicit produc-
tion of opium and illicit manufacture of methamphetamine
are among the most significant drug challenges facing East
and South-East Asia. Trafficking is centred around north-
ern Myanmar, though illicit production and manufacture of
these drugs also occurs in other countries across the region.
Seizures of these drugs increased substantially from 2021 to
2022, and regions neighbouring East and South-East Asia
report seizures of methamphetamine and opium originat-
ing in the region.
724. The area of illicit cultivation of opium poppy in
Myanmar is estimated to have increased by 33 per cent from
2021 to 2022 for a total area of 41,000 ha, predominately in
Shan State. This reverses the trend of a consistent decline in
the area under opium poppy cultivation noted in the coun-
try since 2014. Opium yields also increased from 2021 to
2022, by 41 per cent, to 19.8 kilograms per hectare. As a
result, the estimated production of opium rose by 88 per
cent, from 420 tons in 2021 to 790 tons in 2022. Seizures
of raw opium and heroin in Myanmar were lower in the
period between January and end of October 2022 at 1 ton
and 1.2 tons, respectively, which was approximately half the
quantity seized the year before.
152
UNODC, Regional Office for South-East Asia and the Pacific,
Myanmar Opium Survey 2022: Cultivation, Production and Implications
(Bangkok, 2023).
152
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INCB REPORT 2023
of all ketamine seizures in South-East Asia. According to
UNODC, the proliferation of clandestine labs in the country
enables the illicit manufacturing of ketamine on an indus-
trial scale. This coincided with the Cambodian authorities
having seized in 2022 over 500 tons of various precursor and
pre-precursor chemicals used for the illicit manufacture of
ketamine. Beyond Cambodia, seizures of ketamine are also
on the rise in Shan State, Myanmar, where the substance is
increasingly being illicitly manufactured. Nearly 2.4 tons
were seized in 2022, more than three times the 760 kg
seized in 2021. Similarly, illicit production of ketamine is
also on the rise in Malaysia, with authorities reporting the
dismantling of five clandestine ketamine labs and seizures
of 2.9 tons of the substance in 2022, up from approximately
475 kg the year before.
154
Report 2020.
The most used drugs in the Philippines are
cannabis and methamphetamine.
732. The 2022 Health and Lifestyle Survey, conducted by
the Singapore Institute for Mental Health, found that the
overall prevalence of drug use in the last 12 months among
respondents stood at 0.7 per cent. Furthermore, 41.8 per
cent of respondents that had consumed drugs did so before
the age of 18, with a mean age of onset of 15.9 years old.
733. According to the Office of the National Narcotics
Control Commission of China, its drug prevention educa-
tion efforts, including the “Care for drug users” campaign,
resulted in a further decline of 24.3 per cent of registered
people who use drugs in the country, from 1.49 million
people in 2021 to 1.12 million by the end of 2022. Among
those registered in 2022, 588,000 were using methamphet-
amine, 416,000 were using heroin and 32,000 were using
ketamine.
6. Prevention and treatment
729. Many countries in the region continue to lack mecha-
nisms for gathering information on the scope and nature of
drug use and treatment demand.
The Board encourages the
countries of the region to prioritize the collection of data
on drug use trends and treatment demand to inform the
development of evidence-based approaches in the area
of prevention and treatment and encourages bilateral
partners and regional and international organizations
to provide support to that end.
730. The prevalence of drug use in East and South-East
Asia has remained significant according to data presented
in the UNODC
World Drug Report 2023.
Across multi-
ple drug categories, the annual prevalence of drug use in
the region was largely unchanged from 2020 to 2021. The
most used drug in 2021 was cannabis, with 1.21 per cent
of the population aged 15–64 using the drug, or approxi-
mately 19.2 million people. Methamphetamine and other
amphetamine-type substances were the second most used
group of substances, with a prevalence rate of 0.61 per cent,
or 9.8 million people. The prevalence rate for the use of other
drug categories stood at or below 0.23 per cent.
155
731. According to the official summary of the recently
published 2019 Drug Survey in the Philippines, the
Government’s policies in reducing drug use have been
successful and a trend reversal has been observed by the
Government in this respect. The summary underscores that
the annual user prevalence rate for 2019 in the Philippines
was 2.05 per cent, notably lower than the 2018 global esti-
mate of 5.3 per cent published in the UNODC
World Drug
UNODC, Regional Office for South-East Asia and the Pacific,
Synthetic Drugs in East and South-East Asia.
154
155
South Asia
There are increasing signs that South Asia is being targeted
by traffickers smuggling methamphetamine manufactured
in Afghanistan into markets in Europe and Oceania.
Investigations in the region have shown that proceeds of
drug trafficking are being used to fund terrorism, provide
support to armed groups and fuel political violence in the
region, and instances of the joint trafficking of drugs and
weapons have been reported.
1.
Major developments
734. South Asia, located between the two largest opiate
production areas in the world, South-West Asia and
South-East Asia, is the largest consumer market for opiates
worldwide. The proportion of the total number of opiate
users worldwide who reside in South Asia increased from
about 20 per cent in 2002 to about 39 per cent, equivalent
to 12 million people, in 2021. Other regions with signifi-
cantly large numbers of opiate users are the Near and Middle
East and South-West Asia, which together accounted for
19 per cent of the global total, followed by Europe, which
accounted for about 10 per cent.
735. Narco-terrorism appears to be an increasing prob-
lem in the region, and investigations have indicated that
World Drug Report 2023,
Statistical annex.
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
103
proceeds of drug trafficking are increasingly being used to
fund terrorism, support armed groups and instigate politi-
cal violence. Five instances of the joint trafficking of drugs
and weapons were reported in the reporting period, two by
Bangladesh and one each by India, Malaysia and Myanmar.
736. In 2021, the prevalence of opiate use among those
aged 16–64 in South Asia was estimated at 1.1 per cent,
almost double the estimated global average (0.6 per cent).
Most opiates found in South Asia originate in South-West
Asia and the largest opiate market in South Asia is India,
which was projected to become the world’s most populous
country in 2023. In 2021, with an estimated 11 million
opiate users, India accounted for nearly 90 per cent of the
estimated number of opiate users in South Asia, equivalent
to 34 per cent of the total number of opiate users worldwide.
India also accounted for the largest share (two thirds) of the
heroin seized in South Asia in the period 2017–2021, fol-
lowed by Sri Lanka, at 23 per cent, and Bangladesh, at 7 per
cent. Seizures of heroin in South Asia have seen an overall
increase in the past decade.
737. The production of opium for the licit pharmaceuti-
cal industry in India declined for two decades and, since
2018, has stabilized at between 200 and 300 tons per year.
As reported to authorities by licensed opium farmers, the
overall average quantity of opium produced per hectare
increased from an average of 47 kg per ha in 1995 to about
64 kg per ha in 2021. The authorities in India reported
that most of the opium seized in the country had not been
sourced from licit sources.
738. Opium continues to be illicitly cultivated in India,
primarily in the north-east of the country. In the period
2020–2021, authorities in India reported the eradication of
about 4,400 ha of illicitly cultivated opium poppy, which was
an area of almost the same size as the total area under licit
opium poppy cultivation in the country in 2020 (4,941 ha)
and in 2021 (5,406 ha). Most of the heroin found in South
Asia in recent years appears to have originated primarily in
South-West Asia, having been manufactured from opium
produced in Afghanistan, the world’s largest producer of
the substance. UNODC has reported that traffickers from
Myanmar, which accounted for some 6 per cent of global
illicit opium production in 2021, regularly supply some of
the north-eastern states of India with heroin.
739. The average annual seizures of heroin in South Asia
along the southern route have increased to the extent that
the total quantities of heroin and morphine originating in
Afghanistan that are seized along that route are now larger
than those seized along the northern route, which mainly
supplies markets in the Russian Federation, via Central Asia.
740. In South Asia, methamphetamine manufactured in
Afghanistan reaches both India and Sri Lanka. Most users
of amphetamine-type stimulants (mainly methampheta-
mine) in India are found in the country’s western states,
while the prevalence of methamphetamine use is highest in
its eastern states, close to Myanmar. As individual seizures
suggest, India is increasingly being exposed to the expansion
of methamphetamine trafficking from both South-West and
South-East Asia (mainly originating in Myanmar), which
poses a high risk of significantly increasing the availability
and use of the drug in the country.
2.
Regional cooperation
741. A total of 49 drug control officials from the compe-
tent national authorities of all six countries in South Asia,
namely, Bangladesh, Bhutan, India, Maldives, Nepal and Sri
Lanka, have registered to use INCB Learning e-modules.
There are now five e-modules, covering narcotic drugs,
psychotropic substances, precursors, the international
drug control framework and ensuring the adequate avail-
ability of controlled substances for medical and scientific
purposes. The e-modules are available upon registration
through INCB Learning to officials of competent national
authorities at no cost.
742. In November 2022, the INCB GRIDS Programme
conducted an interregional workshop on public-private
partnerships between Governments and logistics compa-
nies operating in Afghanistan and neighbouring countries.
The workshop was held in Istanbul, Türkiye, and brought
together 42 participants from around the world, including
four from India and Pakistan. The workshop built upon
the success of previous meetings held by INCB since 2018
related to the prevention and misuse of logistics services
for the trafficking of dangerous substances and to pro-
moting cooperation between Governments and logistics
companies.
743. In December 2022, Bangladesh, Bhutan, India,
Maldives and Sri Lanka participated in the INCB Operation
Knockout and exchanged intelligence to identify and
dismantle illicit manufacturing and distribution points
involving non-medical 1,4-butanediol, carisoprodol,
flubromazepam,
gamma-butyrolactone
and ketamine
trafficked through international post, express mail and
courier services and related modalities.
744. In February 2023, the GRIDS Programme organized
an online stakeholder consultation on voluntary coopera-
tion between Governments and freight forwarding services
for the prevention of dangerous substance trafficking. The
event was attended by more than 44 representatives from
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INCB REPORT 2023
10 Governments, three international organizations and six
industry associations, including six participants from India.
Participants exchanged best practices and shared respec-
tive case examples related to the exploitation of legitimate
ancillary logistics services and discussed the next steps for
promoting voluntary cooperation between Governments
and their private sector partners.
745. In Vienna in September 2023, the GRIDS Programme
convened the sixth annual operational meeting on counter-
ing trafficking of dangerous synthetic drugs and chemicals
through postal, courier and air cargo services. The event
brought together 100 officers, experts and industry lead-
ers from over 30 Governments, private sector partners and
international and regional organizations, including partici-
pants from India and the Maldives. Several participating
Governments also engaged in bilateral and multilateral case
meetings to enhance cooperation across borders.
746. The GRIDS Programme convened the third inter-
national expert group meeting on expanding the INCB
lists of dangerous substances with no known legitimate
uses and on novel approaches for their identification in
falsified or illicitly manufactured pharmaceuticals, held in
Vienna from 18 to 22 September 2023. The event brought
together 45 representatives from over 20 Governments and
international organizations, including participants from
India. Participants discussed the latest trends, threats and
approaches for the rapid detection of suspicious packaging
of falsified substances.
747. To better understand the threat posed by opiate
trafficking in South Asia, UNODC held a two-day expert
working group meeting on opiate trafficking along the
southern route, in New Delhi on 10 and 11 May 2023. The
meeting gathered representatives from Bangladesh, Bhutan,
India, Maldives, Mozambique, Nepal and Sri Lanka. The
participants held intensive deliberations on a range of
issues, including key trends in Afghan opiate trafficking,
and country-focused situational analysis, and conducted a
review of the supply of and demand for opiates in the region.
The need for collective regional efforts to strengthen law
enforcement and health responses was emphasized during
the discussions.
748. In July 2023, a five-day training event on drug law
enforcement was held in Faridabad, India, for senior offi-
cials from Antigua and Barbuda, Bhutan, Eswatini, Ethiopia,
Maldives, Seychelles and Tanzania (United Republic of).
The event was co-organized by the Government of India
and UNODC. Aimed at South-South capacity-building, it
provided a further platform for countries to foster coop-
eration and share insights on combating drug trafficking.
The training included presentations on the impact of
cryptocurrency on drug trafficking and emphasized the
significance of technological advancements for law enforce-
ment agencies involved in the disruption of drug smuggling
operations.
749. In October 2023, the Forty-fifth Meeting of Heads
of National Drug Law Enforcement Agencies, Asia and the
Pacific, was held in Bali, Indonesia. The Meeting adopted
a set of recommendations to increase international and
regional cooperation with the aim of preventing and dis-
mantling supply chains for precursor chemicals, reducing
the illicit cultivation and production of drugs and their
trafficking, dismantling clandestine laboratories and pro-
moting best practices in alternative development.
750. The Global Conference on Cooperation in
Enforcement Matters, organized by the Directorate of
Revenue Intelligence of the Ministry of Finance of India,
was held from 30 October to 1 November 2023 in New
Delhi, under the overarching theme “It takes a network to
fight a network”. The objective of the conference was to pro-
mote cooperation and the exchange of information between
national and international law enforcement agencies for
the purpose of combating transnational crime, including
drug trafficking.
751. On 30 November 2022, the Government of India
informed INCB that a memorandum of understanding
on public-private partnership with the chemical industry
in India had been signed between the Central Bureau of
Narcotics of India and the Indian Chemical Council. The
memorandum is intended to prevent the diversion of chemi-
cals from licit distribution channels and includes a voluntary
code of conduct to ensure coordination within the Council.
752. The seventh meeting of the subgroup on the pre-
vention of illicit trafficking in narcotic drugs, psychotropic
substances and precursor chemicals of the Bay of Bengal
Initiative for Multi-Sectoral Technical and Economic
Cooperation was held in Chiang Rai, Thailand, from 7 to
9 December 2022 and involved the participation of rep-
resentatives from all the Bay of Bengal Initiative member
States. Progress achieved during the meeting included
steps towards developing the Bay of Bengal Initiative Plan
of Action on Drug Control.
753. In 2023, the UNODC Global Maritime Crime
Programme continued to deliver regional training pro-
grammes for maritime law enforcement officers in
Bangladesh, Maldives and Sri Lanka. Among the topics
covered in the training was visit, board, search and seizure
tactics, the discussion of which provided participants with
an opportunity to acquire and share knowledge on best
practices in performing maritime interdictions.
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
105
3.
Availability of internationally
controlled substances, including
reporting to the Board
754. The three international drug control treaties require
States parties to furnish statistical reports to the Board on
an annual basis. Those reports enable the Board to monitor
the licit movement of internationally controlled substances
and ensure the availability of those substances for medical,
scientific and industrial purposes. Most countries in South
Asia regularly provide their required statistical reports on
narcotics drugs controlled under the 1961 Convention
as amended. A few countries in the region have not pro-
vided all the required reports regarding narcotic drugs and
psychotropic substances in the past five years.
The Board
encourages Governments in the region to prioritize the
submission of accurate and timely reports, as doing so
will have a significant impact on the effectiveness and
efficiency of the international drug control system.
755. South Asia continues to be the region with the lowest
levels of consumption of opioid analgesics worldwide. In
2021, the level of consumption of opioid analgesics in the
region, expressed in S-DDD
pm
per million inhabitants,
stood at 181 S-DDD
pm
, which was higher than the level
in 2002 (43 S-DDD
pm
) but lower than the level in 2020
(202 S-DDD
pm
). Bhutan was the country with highest con-
sumption in the region in 2021 (47 S-DDD
pm
), followed
by Sri Lanka (35 S-DDD
pm
), Nepal (31 S-DDD
pm
), India
(27 S-DDD
pm
), Maldives (26 S-DDD
pm
) and Bangladesh
(16 S-DDD
pm
). Morphine was the most consumed
opioid in the region (86 S-DDD
pm
), followed by fentanyl
(73 S-DDD
pm
) and pethidine (22 S-DDD
pm
).
756. Determining the levels of consumption of psycho-
tropic substances in South Asia remains challenging because
the countries in the region have failed to consistently pro-
vide the Board with consumption data on psychotropic
substances for the past five years. The Board will continue
to monitor the situation and will continue its dialogue with
the Governments of the region, emphasizing the impor-
tance of regularly furnishing data on the consumption of
psychotropic substances.
757.
The Board stresses that there is insufficient availa-
bility of narcotic drugs and psychotropic substances in the
countries of the region and emphasizes the importance
of ensuring sufficient availability of and access to inter-
nationally controlled substances for medical purposes.
758. With regard to precursor chemicals, in the con-
text of Commission on Narcotic Drugs resolution 49/3,
Member States voluntarily provide estimates of their annual
legitimate requirements for imports of certain precursor
chemicals frequently used in the illicit manufacture of
amphetamine-type stimulants. Among other substances, the
provision of annual legitimate requirements is requested for
ephedrine and pseudoephedrine, substances that also have
medicinal uses, as well as, to the extent possible, for prepara-
tions containing those substances that could be easily used
or recovered by readily applicable means.
759. As at 1 November 2023, all six countries in South
Asia had provided the Board with at least one estimate of
their annual legitimate requirements for imports of ephe-
drine, pseudoephedrine or their preparations, and all six
have regularly updated their estimates for those substances,
which contributes to preventing their oversupply and diver-
sion into illicit channels and ensuring their availability for
legitimate purposes.
760. Further information on the availability of interna-
tionally controlled substances can be found in the technical
reports of the Board for 2023 on narcotic drugs,
156
psycho-
tropic substances
157
and the implementation of article 12
of the 1988 Convention.
158
In addition, the publication
entitled
Guide on Estimating Requirements for Substances
under International Control,
developed by INCB and WHO
for use by competent national authorities, and the docu-
ment entitled “Issues that Governments may consider when
determining annual legitimate requirements for imports
of ephedrine and pseudoephedrine” are available on the
Board’s website.
4. National legislation, policy and
action
761. In November 2022, the Parliament of Sri Lanka
enacted the Poisons, Opium and Dangerous Drugs
(Amendment) Act, No. 41 of 2022. The Act provides amend-
ments to the schedules of controlled substances to include
narcotic drugs, psychotropic substances and precursor
chemicals recently added to the schedules and tables of the
international drug control treaties. The Act, amending the
Poisons, Opium and Dangerous Drugs Ordinance, includes
further legal provisions for monitoring and addressing
emerging trends in methamphetamine misuse in Sri Lanka,
as well as legal provisions to refer persons who are alleged
to have committed an offence under the Act for volun-
tary admission to medical treatment for addiction and to
rehabilitation.
156
157
158
E/INCB/2023/2.
E/INCB/2023/3.
E/INCB/2023/4.
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INCB REPORT 2023
762. In late 2022, the Government of Bangladesh approved
the Drug and Cosmetics Act 2022. The new law follows the
guidelines of WHO related to the legitimate manufacture
of medicines and provides for heavier monetary penalties
and imprisonment terms of up to a lifetime sentence for
manufacturing and commercializing adulterated and fake
medicines.
763. In May 2023, officials from Bangladesh, Bhutan,
India, Maldives, Nepal and Sri Lanka gathered in New Delhi
for the second meeting of the steering committee of the
UNODC regional programme for South Asia for the period
2023–2027. The regional programme provides a strategic
roadmap for focused national and regional cooperation in
building capacities and promoting effective policies to pro-
mote justice and health and prevent and counter drug traf-
ficking, organized crime, corruption and terrorism in the six
countries of South Asia. The steering committee, established
on 1 February 2023, serves as the governing body for the
regional programme. Its responsibilities include reviewing
the Office’s annual work plans for the region, assessing suc-
cesses and challenges in the Office’s operations, providing
guidance and advice, and facilitating communication with
national Governments.
or re-export to Europe, some of it is now being trafficked to
South Asia, reversing the traditional trafficking route, which
involves the transport of heroin from South-West Asia to
Africa, via India. African countries that have been identified
as major transit points for heroin consignments to India
include Kenya, South Africa and Uganda. The trafficking
has mostly been carried out by human couriers, as well as
through parcel post. The diversification of this route is possi-
bly due to an increase in heroin trafficking from the Islamic
Republic of Iran detected by Indian authorities in 2021.
767. Countries in South Asia continued to report seizures
of methamphetamine, in both tablet and crystalline form,
originating in both South-East and South-West Asia, which
suggests that there has been a further integration of the
methamphetamine trafficking networks of the two regions.
768. In 2022, drug-related crimes accounted for almost
20 per cent of all criminal activity in Bhutan, with sub-
stance misuse making up an estimated 78 per cent of all
drug crime, followed by trafficking in narcotic drugs and
psychotropic substances, at 15 per cent. The total number of
drug crimes recorded in the country in 2022 was 761, show-
ing a significant increase of 162 per cent compared with
2021, when 291 drug crimes were reported. These findings
demonstrate a concerning rise in drug-related offences,
highlighting the need for effective measures to address and
combat drug misuse and trafficking in Bhutan.
769. According to a report published by the Royal
University of Bhutan, for people in Bhutan, the porous
border with India has emerged as a major gateway to obtain-
ing marijuana and prescription drugs, with respondents to
a survey conducted by the Royal University citing proxim-
ity and affordability as key drivers for obtaining drugs in
India. Additionally, the availability of drugs through social
networks, such as friends and neighbours, has further facili-
tated access.
770. In Bangladesh, in 2022, a total of more than 43.7 mil-
lion methamphetamine tablets (“yaba”) were seized. A major
trafficking route running from Myanmar to Bangladesh
across their shared border has been identified. Apart from
the influx of drugs via land routes, maritime routes also
pose a significant threat, as evidenced by multiple seizures
of a range of drugs from boats in the vicinity of Cox’s Bazar.
According to the data available, cannabis remains the most
prevalent drug type in Bangladesh. Among the districts iden-
tified by the Department of Narcotics Control of Bangladesh
as the most drug-prone in in the country are Dhaka, Cox’s
Bazar, Chottogram, Comilla and Brahmanbaria. Several
sources have noted a rise in drug trafficking activities in
the country in recent years, associated with the influx of
Rohingya refugees.
5.
Cultivation, production,
manufacture and trafficking
764. South Asia remains an important transit area for
traffickers smuggling illicitly produced opiates from
Afghanistan to Europe and North America. In addition, the
four coastal States in South Asia, namely, Bangladesh, India,
Maldives and Sri Lanka, as well as Pakistan, are exposed to
trafficking because of maritime trafficking routes that cross
the Indian Ocean. India, in particular, has noted an intensi-
fication of trafficking in opiates originating in Afghanistan
and trafficked eastward, along the southern route.
765. Data on seizures effected on the southern route sug-
gest that trafficking in Afghan opiates has increased mark-
edly towards South Asia and Africa, to the extent that the
total quantities of Afghanistan-related heroin and mor-
phine seized on that route are now larger than those seized
along the northern route, which mainly supplies markets in
the Russian Federation, via Central Asia. Traffickers from
Myanmar, which accounted for some 6 per cent of global
illicit opium production in 2021, regularly supply some of
the north-eastern states of India with heroin.
766. In 2021, about one third of the heroin and morphine
seized on the southern route was seized in Africa, while
two thirds were seized in South Asia. Although most of the
heroin shipped to Africa has been for domestic consumption
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771. The Narcotics Control Bureau of India shared real-
time actionable information generated during its Operation
Samudragupt with the authorities of Maldives and Sri Lanka.
The information resulted in seizures of 286 kg of heroin
and 128 kg of methamphetamine and the arrest of 19 drug
traffickers in two operations conducted the by Sri Lankan
Navy, and further seizures of 4 kg of heroin and the arrest of
five drug traffickers by the Maldives Police Service.
772. It appears that the domestic cocaine market in India
is usually supplied by small shipments. While amounts of
cocaine seized in South Asia are typically small, a change
in the methods of cocaine trafficking has been observed. In
2019, seizures of cocaine consignments destined for India,
amounting to 33 kg in total, were mainly effected along
air and land routes, with none reported along sea routes.
In 2020, the restrictions on international air travel may
have spurred an increase in the use of mail services, which
accounted for more than one third of inbound cocaine con-
signments by weight. In 2021, sea transport was the predom-
inant mode of transport used to traffic cocaine into India,
accounting for 95 per cent of inbound cocaine seizures in
terms of weight.
773. As part of the “Drugs Free India” campaign of the
Narcotics Control Bureau of India, which continued during
2022, more than 1,300 kg of heroin were seized in operations
in the State of Gujarat and the cities of Delhi and Kolkata,
and more than 75,000 kg of drugs were destroyed.
774. In July 2022, law enforcement authorities in Nigeria
seized about 22 million tramadol tablets from shipping
containers originating in India. Preliminary investigations
indicated that the consignments had been ordered from
online pharmacies apparently operating from India. The
operators were believed to be supplying narcotic drugs and
psychotropic substances, including substances not under
international control, such as tramadol and tapentadol.
775. Customs authorities in Maldives reported the seizure
of over 118 kg of drugs in 2022, which was a notable increase
from the 50 kg seized in 2021. The seizures indicate that
the trafficking of drugs into Maldives is mostly carried out
through mail or courier services. During the first quarter of
2023, the Maldives Police Service recorded seizures of vari-
ous drugs, including more than 8 kg of cannabis, more than
3 kg of cocaine and more than 2 kg of heroin. In the same
period, 314 Maldivian nationals and 17 foreign nationals
were detained for drug-related offences.
776. Heroin and cannabis oil are the most commonly
used illicit drugs in Maldives, but LSD, MDMA (commonly
known as “ecstasy”) and other synthetic drugs have also
been seized in recent years.
777. Sri Lanka reported that most of the heroin arriving
on its territory in 2019 and 2020 had transited through the
Islamic Republic of Iran (68 per cent in 2019) and that a
much smaller quantity had transited through Pakistan
(11 per cent in 2019). Sri Lankan sea routes are increasingly
being used by local and international narcotics traffickers. In
2021, Sri Lankan authorities reported seizures of 1,594 kg of
heroin and more than 348 kg of synthetic drugs. Maritime
seizures were effected more often on the open sea than in
ports, and the drugs were mostly found on small vessels,
such as untraceable fishing boats.
778. In Bangladesh, it was reported that a small propor-
tion of the heroin seized in 2019 had originated in Myanmar
(5 per cent), while the vast majority had entered the country
through India (95 per cent).
779. The illicit manufacture of ketamine, a substance not
under international control but used as an anaesthetic in
medicinal practice in many countries, has diversified geo-
graphically. Trafficking in the substance has spread beyond
countries in East and South-East Asia and its non-medical
use has recently increased in a few countries in South Asia.
Traffickers have begun exploring new ways to promote
ketamine on the illicit market, with mixtures containing
ketamine and other ingredients that are often unknown to
users appearing in marketed products.
6. Prevention and treatment
780. In South Asia, opioids are the most frequently
reported primary drug of use among people in drug treat-
ment, and their misuse remains the leading cause of fatal
overdoses both in the region and globally; in 2019, their
misuse accounted for nearly 70 per cent of the 128,000
deaths attributed to drug use disorders worldwide.
781. In Bangladesh, UNODC developed a training
module on drugs, crime and HIV/AIDS in collaboration
with the Bangladesh Police Academy, delivered at Dhaka,
which provided training for 50 police officers of the Dhaka
Metropolitan Police. This follows the implementation by
UNODC of a pilot intervention on HIV/AIDS and mental
health in 2022 in collaboration with the Bangladesh prison
authority, together with the Dhaka Ahsania Mission, a non-
governmental organization.
782. At about 2.1 per cent, India had the highest preva-
lence of opioid use in South Asia in 2018, according to the
country’s latest national household survey of drug use, con-
ducted across India in 2018. Opioid use in the country is still
mainly a male phenomenon, with more than 95 per cent of
all opioid users in India being male.
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INCB REPORT 2023
783. A detailed analysis of opioid use in India, based on
the same national household survey of drug use, reveals
that rates of opioid use vary widely within the country.
Among the population aged 10–75, overall rates of opioid
use range between 0.2 and 25.2 per cent, and rates of opioid
use disorders range between 0.1 and 6.9 per cent. The high-
est prevalence of people with opioid use disorders is found
in the eastern parts of the country, while the largest numbers
of people with opioid use disorders are found in states in
north-western India (Uttar Pradesh, Punjab and Haryana),
as well as in some of the central-western states (Maharashtra
and Madhya Pradesh). Traditionally, the prevalence of opiate
use has been high in the country’s north-eastern and north-
western states. However, the high level now also found in
Maharashtra seems to be linked to the increasing quantities
of opiates being trafficked to India from South-West Asia.
784. According to the same household survey, the esti-
mated annual prevalence of cocaine use among the general
population is 0.11 per cent. Although that estimated preva-
lence is well below the global average, as the same study
points out, it nevertheless represents 1.1 million past-year
users, or 5 per cent of the global number of cocaine users.
785. In Sri Lanka, UNODC conducted training for poli-
cymakers on the nature, prevention and treatment of drug
use disorders, as part of its support for Sri Lanka’s efforts to
create humane, effective and evidence-based drug use pre-
vention and drug dependence treatment and care services.
In 2022, Sri Lanka completed three assessment reports:
(a) a review
of the national legal framework relating to the
control of drugs in Sri Lanka;
(b)
a situational and needs
assessment report on drug use, treatment and rehabilitation
and the status of drug prevention; and
(c)
the mapping of
drug demand reduction initiatives.
786. In 2023, UNODC conducted in India training on HIV
prevention, treatment, care and support for people who use
stimulant drugs, with the participation of over 40 govern-
ment, civil society and health representatives from across
India. In June 2023, training was also delivered on establish-
ing and administering opioid substitution agonist therapy.
787. UNODC, in collaboration with the Academy of
Prisons and Correctional Administration of India, organ-
ized a three-day regional consultation on health rights in
prisons with over 75 high-level prison and health officials,
as well as non-governmental organizations, participating.
788.
INCB encourages countries in the region to
improve the availability of internationally controlled
substances for medical purposes, prevent and address
drug trafficking and provide evidence-based prevention,
treatment and rehabilitation services.
West Asia
A significant drop in the 2023 opium harvest in Afghanistan
was reported, which was due to a reduction in opium poppy
cultivation following the strict application of a ban on illicit
drug cultivation that had been announced by the country’s
de facto authorities in April 2022. As affected farmers in
Afghanistan may not have alternative sources of income,
support needs to be provided for alternative development
solutions.
methamphetamine manufacture in Afghanistan has been
increasing over recent years, and methamphetamine origi-
nating in Afghanistan now reaches markets in South-West
Asia, East and South-East Asia, South Asia, Central Asia
and the Southern Caucasus, Africa, Europe and Oceania.
South-West Asia also observed an increase in metham-
phetamine use.
The illicit manufacture of, trafficking in and misuse of syn-
thetic drugs, including new psychoactive substances and
pharmaceutical drugs, continue to pose a significant chal-
lenge to countries in West Asia, in particular in the Central
Asia subregion.
The middle East continues to be seriously affected by
trafficking
in and the use of falsified “captagon”, a chal-
lenge that is further exacerbated by political instability and
ongoing conflicts in some parts of that subregion.
1.
Major developments
789. The
Afghanistan Opium Survey 2023,
released by
UNODC on 5 November 2023, reported a dramatic decline
in opium poppy cultivation across Afghanistan. The area
under cultivation declined by 95 per cent, from 233,000 ha
in 2022 to a total of just 10,800 ha in 2023, with opium
production seeing a similar 95 per cent decline, from
6,200 tons in 2022 to just 333 tons in 2023. In terms of the
supply of heroin from Afghanistan to global illicit markets,
this translates into a reduction of export quality heroin
(with 50–70 per cent purity) from 350–580 tons in 2022
to 24–38 tons in 2023. The international community will
need to monitor the situation closely to determine how illicit
markets around the world will respond to this development.
790. This significant drop in opium production in
Afghanistan is due to a reduction in opium poppy cultiva-
tion following the strict application of the ban on illicit drug
cultivation that had been announced by the country’s de
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
109
facto authorities in April 2022. At the same time, the ban will
have a significant impact on portions of the rural population
in Afghanistan who have relied on opium poppy cultivation
for their livelihoods and do not have alternative sources of
income, and whose situation is being further exacerbated
by the overall economic downturn and humanitarian crisis
in the country.
791. In terms of global illicit opium poppy cultivation, this
reduction places Afghanistan behind Myanmar, where, it
was reported by UNODC, 40,100 ha were cultivated in 2022.
792. While illicit opium and heroin production declined
in Afghanistan, trafficking from the country continued, pos-
sibly owing to the sale of opium inventories stockpiled from
past record harvests. The Balkan route remained the main
path for trafficking in opiates originating in Afghanistan
and headed to markets in Central and Eastern Europe. A
noticeable increase in trafficking in opiates via the southern
route was also observed, with volumes appearing to have
surpassed those trafficked via the northern route, which
supplies markets in the Russian Federation.
793. The increase in illicit methamphetamine manufacture
in Afghanistan is also of serious concern to the Board, as this
substance now reaches markets not only in South-West Asia
but also in East and South-East Asia, South Asia, Central Asia
and the Southern Caucasus, Africa, Europe and even Oceania.
Afghanistan itself observed an increase in methamphetamine
misuse, as did other countries in South-West Asia.
794. The illicit manufacture of, trafficking in and use of
synthetic drugs, including new psychoactive substances and
pharmaceutical drugs, continue to pose a significant chal-
lenge to public health and law enforcement in countries in
West Asia, in particular in the Central Asia subregion.
795. The Middle East continues to be seriously affected by
trafficking in and use of falsified “captagon”,
159
as this region
remains vulnerable to trafficking in this substance due to
political instability and ongoing conflicts in some parts of
the subregion. Seizures of this substance reached a record
high in the subregion in 2021, almost double the amount
recorded in 2020. In addition, the subregion is witnessing
the development of a methamphetamine market as seen
from a rise in seizures of that substance.
2.
Regional cooperation
796. The sixteenth Policy Consultative Group meeting of
the Paris Pact Initiative was organized by UNODC in Vienna
on 5 and 6 December 2022; it was attended by 135 partici-
pants representing 37 countries and 13 international and
regional organizations. The meeting discussed current and
emerging drug trafficking patterns and trends, recent opera-
tional developments in Afghanistan, the progress made by
the Paris Pact programme, and the UNODC regional pro-
gramme for Afghanistan and neighbouring countries. The
operational priority recommendations stemming from the
expert meetings held in 2022 in relation to the four pillars
of the Vienna Declaration were reviewed and endorsed by
the Group.
797. In accordance with the 2022 action plan of the
Central Asian Regional Information and Coordination
Centre (CARICC), the regional anti-drug law enforce-
ment operation “Reflex-2022” was carried out by CARICC
member States from 3 to 22 December 2022. As a result of
the operation, various amounts of new psychoactive sub-
stances and other synthetic narcotic drugs and psychotropic
substances were seized, and several clandestine drug labo-
ratories were dismantled.
798. From December 2022 to January 2023, Lebanon,
Qatar, Saudi Arabia, Türkiye and the United Arab Emirates
participated in the Board’s Operation Knockout, during
which they exchanged intelligence to identify and disman-
tle illicit manufacturing and distribution points involving
non-medical carisoprodol, 1,4-butanediol, flubromazepam,
gamma-butyrolactone
and ketamine trafficked through
post, express mail and courier services.
799. On 15 February 2023, India chaired a virtual meet-
ing of the Expert Working Group on Law Enforcement
and Drug-Related Crimes of the Meeting of the Heads
of the Competent Authorities for Combating Illicit Drug
Trafficking of Member States of the Shanghai Cooperation
Organization. Participants shared experiences in carrying
out activities to implement the Organization’s Anti-Drug
Strategy 2018–2023 and discussed the challenges and suc-
cesses in addressing drug trafficking in the region.
800. On 27 April 2023, the 37th meeting of the Working
Group on Afghanistan at the Ministerial Council of the
Collective Security Treaty Organization (CSTO) was
held. The event was attended by delegations from CSTO
member States (Armenia, Belarus, Kazakhstan, Kyrgyzstan,
the Russian Federation and Tajikistan), the CSTO Deputy
Secretary General, the Chargé d’affaires of Afghanistan in the
Russian Federation, representatives of the United Nations
Regional Centre for Preventive Diplomacy for Central
Captagon was originally the official trade name for a pharmaceutical
preparation containing the substance fenethylline, a synthetic stimulant. As
encountered in seizures across West Asia today and referred to in the present
report, “captagon” is a falsified drug compressed into pills or tablets that are
similar in appearance but distinct from the earlier pharmaceutical prepara-
tion Captagon. The active ingredient in falsified “captagon” is amphetamine,
which is typically cut with multiple adulterants, such as caffeine.
159
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INCB REPORT 2023
Asia, the Commonwealth of Independent States Anti-
Terrorism Centre, the Coordination Service of the Council
of Commanders of Border Troops of the Commonwealth
of Independent States and the International Committee
of the Red Cross. Participants discussed the situation in
Afghanistan, including the humanitarian, economic, secu-
rity and drug trafficking challenges faced by the country.
801. A meeting of the Foreign Ministers Council of the
Shanghai Cooperation Organization took place on 4 and
5 May 2023, in Panaji, India, chaired by the Minister for
Foreign Affairs of India. At the meeting, the ministers of
foreign affairs of China, Kazakhstan, Kyrgyzstan, Pakistan,
the Russian Federation, Tajikistan and Uzbekistan, as well
as the Secretary-General of the Shanghai Cooperation
Organization and the Director of the Executive Committee
of the Regional Anti-Terrorist Structure of the Shanghai
Cooperation Organization, agreed to deepen cooperation
on security matters and to step up their combined efforts to
fight terrorism, extremism, separatism, drug trafficking and
cybercrime. Special attention was accorded to Afghanistan
and ways in which the Organization could assist the
country in its efforts to stabilize and rebuild its economy.
Memorandums granting Kuwait, Maldives, Myanmar and
the United Arab Emirates dialogue partner status with the
Organization were signed during the meeting.
802. On 26 May 2023, in Yerevan, the Chair of the
Coordinating Council of the Heads of the Competent
Authorities for Countering Illicit Drug Trafficking of the
CSTO member States, the Deputy Minister of Interior
of the Russian Federation and the Minister of Interior of
Armenia discussed preliminary results of the CSTO subre-
gional anti-drug operation “Channel-Arax”. The operation,
which involved CSTO member States, as well as observers
from China, the Syrian Arab Republic, CARICC, UNODC,
the Eurasian Group on Combating Money Laundering
and Financing of Terrorism, and the Council of Financial
Intelligence Heads, was conducted from 22 to 26 May 2023
on the territory of CSTO member States with the aim of
disrupting illicit channels supplying controlled drugs and
new psychoactive substances. As a result of the operation,
which included a number of international controlled deliv-
eries, large amounts of controlled substances were seized,
including cannabis, cannabis resin, heroin, mephedrone
and MDMA, and three clandestine drug laboratories were
dismantled.
803. On 8 and 9 June 2023, INCB Learning held a two-day
virtual workshop focused on raising awareness about the
availability of controlled substances for medical and scien-
tific purposes as part of the Board’s ongoing efforts to sup-
port Member States in ensuring that essential medicines are
available while preventing their diversion and misuse. The
event brought together officials from the competent national
authorities of seven Russian-speaking countries – Armenia,
Azerbaijan, Belarus, Kyrgyzstan, the Russian Federation,
Tajikistan and Uzbekistan – and a diverse group of stake-
holders which included representatives from palliative care
associations, experts in drug control and public health, and
members of the international community. Throughout the
two days, participants discussed various themes related
to improving access to controlled substances for medical
purposes, including regulatory frameworks, barriers to
access and the importance of national and international
cooperation.
804. A total of 38 drug control officials from the com-
petent national authorities of 14 countries in West Asia,
namely, Afghanistan, Armenia, Azerbaijan, Georgia, Iraq,
Jordan, Lebanon, Pakistan, Qatar, Saudi Arabia, Tajikistan,
Türkiye, the United Arab Emirates and Yemen, have regis-
tered to use INCB learning e-modules.
805. The Paris Pact Expert Working Group meeting on the
diversion of precursor chemicals, linked to the third pillar
of the Vienna Declaration, was held on 13 and 14 June 2023
in Sofia in hybrid format. The meeting, which was attended
by over 140 participants representing 34 countries and 10
international and regional organizations, reviewed the latest
trends, existing gaps and challenges, and shared their recent
operational actions in tackling trafficking in controlled sub-
stances and their precursors along the main drug trafficking
routes from Afghanistan. Delegates also noted with concern
the increase in trafficking in methamphetamine originating
in Afghanistan and the trafficking flows of related precur-
sors. The meeting proposed 10 priority operational recom-
mendations to be further reviewed and endorsed at the 17th
Policy Consultative Group Meeting, which was scheduled to
be held in Vienna on 11 and 12 December 2023.
3.
Availability of internationally
controlled substances (including
reporting to the Board)
806. The three international drug control treaties require
the States parties to furnish statistical reports to the Board
on an annual basis. These reports enable the Board to moni-
tor licit activity involving internationally controlled sub-
stances as well as ensure the availability of these substances
for licit medical, scientific and industrial purposes.
807. Since 2002, the level of consumption of opioid anal-
gesics in West Asia, expressed in S-DDD per million inhab-
itants, has been steadily increasing and reached a total of
23,884 S-DDD
pm
in 2021. This represents a considerable
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
111
increase compared with the level of 2,985 S-DDD
pm
in 2002.
The highest consumption in 2021 was reported by Israel
(18,340 S-DDD
pm
), which was followed at a distance by
Bahrain (2,007 S-DDD
pm
), Türkiye (711 S-DDD
pm
), Qatar
(531 S-DDD
pm
), Kuwait (477 S-DDD
pm
), Saudi Arabia
(342 S-DDD
pm
) and Oman (312 S-DDD
pm
). Almost no
consumption was reported by the remaining countries, with
Afghanistan, Iraq, Pakistan, Tajikistan and Turkmenistan
reporting nil or 1 S-DDD
pm
. Consumption was greatest
for fentanyl (19,004 S-DDD
pm
), followed by oxycodone
(4,023 S-DDD
pm
), morphine (574 S-DDD
pm
) and pethi-
dine (178 S-DDD
pm
).
808. Among the countries and territories of West Asia,
reporting performance has generally been good for the psy-
chotropic substances controlled under the 1971 Convention;
nearly all countries have provided the required reports for
the last five years.
809. Despite satisfactory submission of reports, West Asia
is among the regions that are of particular concern with
regard to ensuring and monitoring the availability of nar-
cotic drugs and psychotropic substances for medical and
scientific purposes. It remains challenging to determine the
levels of consumption of psychotropic substances in West
Asia as approximately half of the countries in the region
have not provided to the Board consumption data on any
psychotropic substance for the past five years.
810.
The Board notes that, while the availability of nar-
cotic drugs and psychotropic substances has been improv-
ing in some countries in the region, there remains an
urgent need to address this matter and ensure that licit
requirements for medical and scientific purposes are met.
811. Out of the 25 countries in West Asia, 22 have regu-
larly provided the Board with updated annual legitimate
requirements for imports of ephedrine, pseudoephedrine
or their preparations. This information is essential for pre-
venting the oversupply and diversion into illicit channels of
such substances, as well as for ensuring their availability for
legitimate purposes.
812. Further information on the availability of interna-
tionally controlled substances can be found in the tech-
nical reports of the Board for 2023 on narcotic drugs,
160
psychotropic substances
161
and the implementation of article
12 of the 1988 Convention.
162
In addition, the publication
entitled
Guide on Estimating Requirements for Substances
under International Control,
developed by INCB and WHO
160
161
162
for use by competent national authorities, and the docu-
ment entitled “Issues that Governments may consider when
determining annual legitimate requirements for imports
of ephedrine and pseudoephedrine” are available on the
Board’s website.
4. National regulation, policy and
action
813. Within the framework of the INCB GRIDS
Programme, INCB and partner organizations conducted
an interregional workshop from 28 to 30 November 2022
on public-private partnerships between Governments and
logistics companies operating in Afghanistan and neigh-
bouring countries. The workshop was held in Istanbul,
Türkiye, and brought together 42 participants from around
the world, including eight private sector participants from
Afghanistan, Iran (Islamic Republic of) and Kazakhstan.
This workshop built upon the success of previous meet-
ings held by INCB since 2018 related to the prevention and
misuse of logistics services for trafficking in dangerous sub-
stances and promoting cooperation between Governments
and logistics companies.
814. In January 2023, the Head of State of Oman approved
the National Strategy for Combating Narcotic Drugs and
Psychotropic Substances for 2023–2028, which identi-
fied policies, programmes and organizational activities to
address trafficking in and the use of narcotic drugs and
psychotropic substances, including through youth-centred
initiatives as well as targeted specialized programmes for
treatment, rehabilitation and social reintegration.
815. On 10 January 2023, with a view to addressing the
increased threat to public health posed by the misuse of
pharmaceutical preparations containing controlled sub-
stances, the President of Turkmenistan adopted a decree
adding new preparations to the national list of controlled
substances, including pregabalin, zopiclone and tapentadol.
816. In February 2023, the INCB GRIDS Programme
delivered two back-to-back awareness-raising and capacity-
building workshops on the safe interdiction of synthetic
opioids and related chemicals for 10 front-line officers in
Armenia and 17 customs and regulatory officers in Georgia.
The training emphasized capacity-building to enhance com-
munications by authorities of both countries concerning
safe handling and interdiction approaches for dangerous
substances.
817. On 8 March 2023, the de facto authorities of
Afghanistan issued a decree banning cannabis cultivation
in Afghanistan and stating that, in case of a violation, the
E/INCB/2023/2.
E/INCB/2023/3.
E/INCB/2023/4.
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INCB REPORT 2023
plants would be destroyed and violators would be punished
according to sharia laws. This decree, as well as the earlier
decree of 3 April 2022, which banned illicit drug cultiva-
tion, including opium poppy, comprise a series of legislative
acts adopted by the de facto authorities aimed at eradicating
illicit drug cultivation and production in the country.
818. In March 2023, Türkiye adopted the “7th Justice
Package” containing several changes to national legislation,
including the Penal Code, the Criminal Procedures Act and
the Control of Narcotic Substances Act. The changes intro-
duced by this legislative package include such measures
as pretrial destruction of drugs, modification of penalties
applicable to drug-related offences, strengthening of pro-
cedures for release and probation, and improvement of the
drug-treatment referral system within the criminal justice
process.
819. On 29 June 2023, the Government of Kazakhstan
approved the Comprehensive Plan to Combat Drug
Addiction and Drug Trafficking for the period 2023–2025.
The plan consists of a series of activities aimed at addressing
drug use and criminality, with particular attention accorded
to the illicit production of synthetic substances, the misuse
of prescription drugs, cannabis trafficking and the issue
of opiates. The activities include equipping border check-
points with inspection equipment to detect drugs, precur-
sors and equipment for drug laboratories, strengthening
forensic examination bodies for the accelerated study of
new synthetic drugs, introducing screening to identify drug
addiction at an early stage and analysing the drug situation
together with the development of adequate drug prevention
measures.
820. The Board notes with concern the public reports over
the continued use of capital punishment for drug-related
offences in some countries of the region.
In this regard,
the Board wishes to reiterate its position that, although
the determination of sanctions applicable to drug-related
crime remains the prerogative of the States parties to
the conventions, the Board encourages States that have
abolished capital punishment for drug-related offences
not to reintroduce it, and it encourages those States that
retain capital punishment for that category of offence to
commute death sentences that have already been handed
down and to consider abolishing the death penalty for
drug-related offences.
821. In June 2023, the Council of Ministers of the United
Arab Emirates approved the formation of the Anti-Drug
Council. The Council will develop an integrated national
strategy for drug control, including drug use prevention,
awareness of forms of harm associated with drugs, and
promotion of early detection of drug use. The Council is
also responsible for following up on the implementation of
plans to combat trafficking in drugs through its ports, land
borders and coasts.
822. The INCB GRIDS Programme organized the sixth
annual operational meeting on countering trafficking in
dangerous synthetic drugs and chemicals through postal,
courier and air cargo services, held in Vienna from 11 to
15 September 2023. The event brought together over 100
officers from 30 Governments and international organiza-
tions, including 10 participants from Türkiye and the United
Arab Emirates. Several participating Governments also con-
ducted bilateral and multilateral case meetings – facilitated
by INCB – to enhance cooperation across borders.
823. The INCB GRIDS Programme convened the third
international expert group meeting on expanding the Board’s
lists of dangerous substances with no known legitimate use
and novel approaches for their identification in falsified or
illicitly manufactured pharmaceuticals, held in Vienna from
18 to 22 September 2023. The event brought together 45
representatives from over 20 Governments and international
organizations and the private sector, including four partici-
pants from Türkiye and the United Arab Emirates.
824. The INCB GRIDS Programme and the Precursors
Control Section jointly organized training on GRIDS
Intelligence tools and chemical precursors for officers from
the Gulf Cooperation Council countries in Vienna from
2 to 5 October 2023. The training was attended by 14 par-
ticipants from four member States of the Gulf Cooperation
Council: Kuwait, Oman, Saudi Arabia and the United Arab
Emirates.
5.
Cultivation, production,
manufacture and trafficking
825. The area under illicit opium poppy cultivation in
Afghanistan declined by 95 per cent, from 233,000 ha in
2022 to a total of just 10,800 ha in 2023. A similar 95 per cent
decline was observed for illicit opium production, which fell
from 6,200 tons in 2022 to just 333 tons in 2023.
826. The impact on global drug markets of the ban
announced in April 2022 by the de facto authorities of
Afghanistan on the cultivation of opium poppy and other
types of narcotic drugs, as well as the more recent ban on
the cultivation of cannabis issued in March 2023, remains
to be seen.
827. In the areas visited by its field teams, UNODC
observed that the opium poppy ban was being strictly
enforced. For example, land cultivated with opium poppy
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was ploughed under at the farmers’ cost, with the farmers
paying for the fuel and providing labour as punishment.
Some farmers were trying to clandestinely grow poppy on
private premises, in greenhouses, in vineyards or in remote
areas, but when the de facto authorities discovered such
instances, the plants were destroyed and in some cases the
farmers were arrested.
828. The farm-gate price of illicit opium dramatically
increased from late 2022 into 2023, with the average price
in August 2023 being $408, which was nearly five times the
price in the 24-month period prior to the takeover by the
Taliban.
829. In 2022, the Balkan route, which passes through the
Islamic Republic of Iran, Türkiye and the Balkan countries,
continued to be the main route for trafficking in opiates
from Afghanistan to destination markets in Central and
Western Europe. According to recent seizure data, traffick-
ing in Afghan opiates has increased markedly along the
southern route, which runs through the Islamic Republic
of Iran and Pakistan and then by sea or air to Europe, either
directly or through South Asia, Africa or the Gulf. In fact,
the total quantities of Afghanistan-related heroin and mor-
phine seized along the southern route are now larger than
those seized along the northern route, which passes through
Central Asia and primarily supplies markets in the Russian
Federation.
830. The total volume of opiates seized by CARICC
member States, most of which are located along the north-
ern route, decreased by 16 per cent in 2022 (6.4 tons) as
compared with 2021 (7.6 tons). In particular, the volume
of heroin seized by these States decreased 30 per cent, from
5.5 tons in 2021 to 3.9 tons in 2022, while seizures of opium
increased slightly by about 6 per cent, from 1.7 tons in 2021
to 1.8 tons in 2022.
831. Iran (Islamic Republic of) and Türkiye, which are
both located at the forefront of the Balkan route, with the
former serving also as one of the entry points for the south-
ern route, reported a significant decrease in the amount of
heroin seized in 2022 compared with previous years. Türkiye
seized 7.9 tons of heroin in 2022, the lowest recorded sei-
zures in the past five years and representing a 64 per cent
decrease compared with 2021 when 22.2 tons of heroin were
seized. Similarly, in the Islamic Republic of Iran, the amount
of heroin seized decreased by 32 per cent (17.2 tons seized
in 2022) compared with the previous year (25.4 tons seized
in 2021). The authorities of both countries explain that this
decrease could be due to strengthened law enforcement
activities at the borders as well as efforts by traffickers to
seek alternative routes, including use of maritime trafficking
over the southern route.
832. The Islamic Republic of Iran also observed a 36 per
cent decrease in opium seizures in 2022 (536 tons) as com-
pared with 2021 (835 tons) and an almost threefold reduc-
tion in morphine seizures in 2022 (12.5 tons) compared with
2021 (36.5 tons).
833. The manufacture of and trafficking in synthetic drugs
continue to pose significant challenges to the countries in
West Asia, in particular in the Central Asian subregion,
which has seen an increase in the number of drug-related
offences involving these substances. CARICC member
States observed a 24 per cent increase in the number of
clandestine laboratories detected and dismantled that had
been used for the manufacture of synthetic drugs, includ-
ing new psychoactive substances such as synthetic cannabi-
noids, synthetic cathinones and phenethylamines, on their
territories: 323 laboratories detected in 2022 compared with
260 in 2021. Kazakhstan dismantled 70 such laboratories in
2022 compared with 37 in 2021, and Kyrgyzstan dismantled
11 laboratories in 2022 compared with 3 in 2021.
834. Some contributing factors to the increase in the
manufacture of and trafficking in synthetic drugs appear
to be the relative simplicity and low cost of manufacturing
these substances, the lack of effective regulation and the
ease of access to the latest information on manufacturing
techniques for these substances, as well as the active use
of information technologies, including the Internet and
social media platforms, for open and closed marketing and
trade in those substances. Frequent use of postal services
for the dispatch of synthetic drugs has also been reported
by Central Asian States.
835. In this regard, the Board noted that a very low
number of countries in Central Asia are making active use
of the IONICS and PICS online platforms for communicat-
ing incidents involving illicit drugs and new psychoactive
substances and their precursors.
The Board would like
to encourage all countries concerned to strengthen the
active use of these tools developed by INCB for the devel-
opment and exchange of both strategic and operational
intelligence related to latest trafficking trends and modi
operandi used by traffickers involved in the illicit manu-
facture of and trafficking in these substances.
836. Central Asian States also expressed concern regard-
ing the threat of trafficking in pharmaceutical preparations
containing controlled substances affecting their territories,
such as tramadol, zopiclone, pregabalin, zaleplon and other
substances.
837. Central Asian States and Azerbaijan reported an over-
all increase in seizures of psychotropic substances in 2022
compared with 2021. In particular, Azerbaijan, Kazakhstan
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INCB REPORT 2023
and Uzbekistan reported some increases in amphetamine
seizures. Azerbaijan and Kyrgyzstan observed an increase in
methamphetamine seizures, while Kazakhstan also reported
an increase in MDMA seizures.
838. A significant reduction in opium cultivation in
Afghanistan could shift traffickers towards synthetic drug
manufacture as the country is already becoming a major
producer of methamphetamines in the region. According to
UNODC, it appears that methamphetamine in Afghanistan
is produced from the ephedra plant, which grows wild in
the country; from pharmaceutical ephedrine extracted from
over-the-counter cold medications; and, potentially, from
ephedrine trafficked into the country. With a view to devel-
oping effective responses to the threat posed by the manu-
facturing of methamphetamine in Afghanistan, the Board
wishes to encourage UNODC and other partners working
in the region to support efforts to conduct detailed chemical
analysis of methamphetamine samples in order to identify
manufacturing methods and the nature of the chemicals
used in that process.
839. Illicit methamphetamine manufacture in Afghanistan
has increased and trafficking in that substance from
Afghanistan now reaches markets beyond South-West Asia,
namely East and South-East Asia, South Asia, Central Asia
and the Southern Caucasus, as well as in Africa, Europe
and Oceania.
163
In May 2023, an estimated record amount
of 2.5 tons of methamphetamine, worth approximately
$1.45 billion on the illicit market, was seized in Indian ter-
ritorial waters jointly by the Indian Narcotics Control Board
and the Indian Navy as part of an operation targeting mari-
time trafficking in drugs originating from Afghanistan.
840. South-West Asia saw a marked increase in meth-
amphetamine seizures in 2022. In particular, the Islamic
Republic of Iran has continued to record substantial
increases in methamphetamine (crystalline) seizures in
recent years. In 2022, it seized 30.4 tons of that substance,
compared with 25.1 tons in 2021, for an increase of 21 per
cent. Pakistan saw a large increase in methamphetamine
seizures in 2022 (4.4 tons seized in 2022, compared with
1.7 tons in 2021).
841. Türkiye has observed considerable increases in sei-
zures of methamphetamine since 2019, with the highest ever
annual seizure recorded in 2022, when 77.7 tons were seized,
representing a more than twofold increase since 2019. This
may be linked to the ongoing smuggling of methampheta-
mine (potentially of Afghan origin) into the country from
or through the neighbouring Islamic Republic of Iran. While
the drug may be transiting through on its way to markets in
163
East and South-East Asia, Central Asia, Europe and North
Africa, some of it may also end up in the domestic market
in Türkiye. While methamphetamine in crystal form is fre-
quently seized in the country, significant amounts of liquid
methamphetamine are also seen in Türkiye. The Turkish
authorities have expressed concern that criminal groups are
venturing into trafficking in liquid methamphetamine as it
could provide more opportunities for concealment from
law enforcement detection. In some provinces, especially in
Istanbul, facilities have been identified where liquid meth-
amphetamine is converted into crystalline form.
842. Türkiye also reported that synthetic cannabinoids,
used in the form of cigarettes, and more recently electronic
cigarettes, continue to be the largest new psychoactive sub-
stances category detected in the country, despite control
measures including generic classification approaches taken
at the global and national scale. However, their seizures
decreased in Türkiye by 53 per cent in 2022 (about 1 ton)
compared with 2021 (about 2.2 tons).
843. The manufacture of and trafficking in falsified “cap-
tagon” continued to seriously endanger public health and
security in countries in the Middle East, a subregion that
remains vulnerable to trafficking in this substance due to
continued political instability, economic challenges, ongoing
conflicts and established demand for the substance. Seizures
of this substance reached a record high in the subregion in
2021 (86 tons), almost doubling the seizure figures recorded
in 2020. Significant seizures during the reporting period
were reported by Kuwait, Saudi Arabia and the United Arab
Emirates. Individual seizures also indicate increased use of
the territory of Iraq and Jordan for trafficking the drug from
the Syrian Arab Republic.
844. In general, “captagon” tablets manufactured in
Lebanon and the Syrian Arab Republic continue to supply
large consumer markets in countries in the Gulf by means
of smuggling directly by land or sea or indirectly with ship-
ments through other regions, such as Southern Europe.
Seizure data suggest that there appear to be new destinations
for this substance in North and West Africa. In addition,
Türkiye reported continued significant increases in “capta-
gon” seizure incidents and quantities in 2022 (almost 24 mil-
lion tablets), when seizures of that substance increased by
73.6 per cent compared with 2021 (almost 14 million tab-
lets) and almost tenfold compared with 2020 (2.8 million
tablets).
845. UNODC notes that, in parallel to “captagon”
trafficking, a methamphetamine market seems to be devel-
oping in the Middle East, as shown by a rise in seizures
of that drug. In 2020, total seizures of methamphetamine
World Drug Report 2023.
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reported in the subregion amounted to 25.67 tons, while the
total in 2021 amounted to 34.2 tons.
846. South-West Asia remains one of the major produc-
tion and trafficking subregions for cannabis resin, account-
ing for 35 per cent of total global seizures in the period
2017–2021. The Middle East appears to be affected less
significantly by trafficking in this substance, accounting
for 2 per cent of global seizures during that period. There
has been an overall decline in cannabis resin seizures in
both subregions in 2021, the trend being mainly affected
by a major decline in Afghanistan (from 422 tons in 2020
to 159 tons in 2021) and Pakistan (from 354 tons in 2020
to 165 tons in 2021). Although the Islamic Republic of Iran
saw an increase of 15 per cent from 2020 (108 tons) to 2021
(124 tons), in 2022 there was drastic decline in seizures of
cannabis resin in that country (77 tons seized, representing
a 46 per cent decrease from 2021).
847. Within West Asia, Afghanistan remained the country
where most of cannabis resin was seized in 2020 and 2021,
followed by Pakistan, the Islamic Republic of Iran, Türkiye
and Lebanon. Cannabis resin originating in Afghanistan
is trafficked through Central Asia, mainly to destinations
within the subregion and the Russian Federation. Cannabis
resin produced in Lebanon is trafficked to other countries
in the Middle East and Europe.
848. Although it is challenging to have an accurate esti-
mate of illicit cannabis cultivation due to the lack of sys-
tematic data collection in most countries, the limited data
available during the period 2011–2021 suggest that there
is sizeable illicit cannabis cultivation in West Asia, in par-
ticular in Afghanistan, Azerbaijan, Kazakhstan, Kyrgyzstan,
Lebanon and Uzbekistan.
849. Central Asian countries continued to take measures
to address illicit cannabis cultivation and conduct yearly
eradication campaigns. Cannabis produced in Central
Asia is mainly destined for domestic markets, with limited
amounts being trafficked to the Russian Federation and
sometimes to Europe. Kazakhstan continued to observe an
increase in the cultivation of cannabis in 2022, with 276
instances of illicit cannabis cultivation being detected for
an increase of 16 per cent from the previous year. Increases
in cannabis cultivation were also identified in Kyrgyzstan
and Tajikistan, while Uzbekistan observed some decline.
850. Countries in West Asia, South-West Asia and the
Middle East reported combined seizures of 62 tons of can-
nabis in 2021 compared with 15 tons in 2011, indicating an
overall increase in trafficking over that period. On the other
hand, Central Asia and the Southern Caucasus combined
witnessed a decline, with seizures totalling 14 tons of can-
nabis in 2021 compared with 34 tons in 2011. In the Middle
East, Israel and Lebanon were the two countries most fre-
quently mentioned by countries responding to the UNODC
annual report questionnaire as being the countries of origin,
departure and transit of cannabis seizures during the period
2017–2021, while in South-West Asia, Afghanistan was
mentioned most frequently, and in Central Asia, it was
Kazakhstan and Kyrgyzstan that were mentioned most
frequently.
851. In CARICC member States, drugs of the cannabis
group (cannabis and cannabis resin) continued to maintain a
prevailing share (almost 53 per cent, or 28.8 tons) in the total
amount of drugs seized in 2022 (55 tons). In 2022, 21.6 tons
of cannabis were seized in CARICC member States, which
was 30 per cent less than in 2021 (30.4 tons); a decrease
was observed in Kazakhstan, the Russian Federation and
Uzbekistan, while Azerbaijan, Kyrgyzstan and Tajikistan
witnessed some increase. In 2022, 7.2 tons of cannabis resin
were seized in CARICC member States, which is 2.6 per cent
more than in 2021 (7 tons). Seizures of cannabis increased
in Kyrgyzstan by 14.1 per cent, in Tajikistan by 20.3 per cent
and in Uzbekistan by 25 per cent; in other States, there was
a decrease in the range of 11–33 per cent.
852. Trafficking in “skunk”, a highly potent form of canna-
bis, represents a challenge in Türkiye. The country reported
that while there had been a decrease in the overall amount of
cannabis seizures in the period 2020–2022, “skunk” seizures
saw significant increases during that period. In particular,
the total amount of cannabis seized in 2022 was 63.3 tons
and represented a decrease of 28 per cent compared with
2020. At the same time, “skunk” seizures reached 8.6 tons
in 2022, representing an increase of 56 per cent compared
with the previous year.
853. Yemen, a country that has endured extreme con-
flict in the past several years, continued to see widespread
cultivation and use of khat (Catha
edulis),
a plant-based
substance not under international control. It appears that
farmers in Yemen cultivate khat mainly for domestic con-
sumption, although some of it is smuggled to Saudi Arabia.
Continued conflict appears to have further contributed to
increases in the cultivation and use of khat as people are
attempting to sustain their livelihoods. Consumption of the
substance appears to have remained stable despite the con-
flict. At the same time, since khat is a water-intensive crop,
increased cultivation might further contribute to overall
water scarcity in the country. Limited information avail-
able suggests that Yemen is also affected by trafficking in
other drugs, including cannabis resin, methamphetamine,
“captagon”, heroin, cocaine and mephedrone.
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INCB REPORT 2023
854. Türkiye is increasingly being used as a transit coun-
try for cocaine arriving from Latin America or transiting
through Western Africa towards destination markets in
Europe via the Balkan route. Since 2014, the amount of
the drug seized in the country has increased sevenfold to
a record 2.8 tons in 2021. Some cocaine transiting Türkiye
is also destined for markets in the Middle East. In 2022,
Türkiye seized 2.3 tons of cocaine, representing an 18 per
cent decrease from 2021. On 24 March 2023, the Peruvian
authorities reported that they had seized 2.3 tons of cocaine
disguised as ceramic tiles destined for Türkiye via an
expanding maritime trafficking route; they believed this was
the first-ever instance of cocaine departing from a Peruvian
port with a destination of Türkiye. Another major incident
involving cocaine trafficking was the seizure by Dutch cus-
toms of 1.1 tons of cocaine from a container that arrived
from Türkiye on 16 May 2023 at the port of Rotterdam.
855. Israel and Lebanon appear to be the most promi-
nent domestic markets for cocaine in West Asia region.
Israel identified Egypt, Libya and Lebanon (in that order)
as the main transit countries for cocaine entering its terri-
tory. Since 2019, Brazil, Czechia, Germany, Greece, Italy,
Panama, Paraguay and Ukraine have identified Israel as the
destination for certain cocaine consignments seized in those
countries.
858. Central Asia continued to be the subregion with
high prevalence of opiate use (0.9 per cent, compared with
a global average of 0.6 per cent).
859. South-West Asia had the highest prevalence of HIV
among people who inject drugs (29.3 per cent, or 225,000
people, compared with the global average of 11.9 per cent).
860. In 2022, a downward trend in the number of people
registered with drug treatment facilities was observed
in Kazakhstan (18,136 compared with 18,782 in 2021),
Kyrgyzstan (7,672 compared with 8,226 in 2021) and
Tajikistan (4,381 compared with 4,749 in 2021). A slight
increase in that number was seen in Azerbaijan (35,097
compared with 34,602 in 2021) and Uzbekistan (5,365 com-
pared with 5,035 in 2021).
861. The non-medical use of synthetic drugs, including
prescription drugs and new psychoactive substances, is
becoming of increasing concern in Central Asia and the
Southern Caucasus. Uzbekistan reported that in 2022,
40.5 per cent of those who received in-patient treatment
were synthetic drug users, including pharmaceutical prepa-
rations with psychoactive effects, while cannabinoid users
were the second most common (17.8 per cent), followed by
polydrug (16.8 per cent) and heroin users (15.5 per cent).
862. According to a recent study conducted in Türkiye
among persons who had been investigated for drug-related
offences during 2022, cannabis remained the most com-
monly used drug (49.2 per cent), followed by metham-
phetamine (24.9 per cent), heroin (6.8 per cent), synthetic
pharmaceuticals (5.9 per cent) and synthetic cannabinoid
(also locally called
bonzai,
accounting for 4.3 per cent).
Türkiye also reported that among the total number of
patients who received treatment in health facilities in 2022
(a total of 302,911 outpatient and 18,187 in-patient appli-
cants), 37.4 per cent were treated for heroin use (represent-
ing a reduction from 43 per cent in 2021), 37.8 per cent
were treated for methamphetamine use (significant increase
from 25.6 per cent in 2021), 7 per cent were treated for can-
nabis use (down from 11.6 per cent in 2021), 1.3 per cent
were treated for synthetic cannabinoids use (reduction from
5.8 per cent in 2021), 7 per cent were treated for opiates
use (increase from 4.2 per cent in 2021), 2.9 per cent were
treated for cocaine use (2.7 per cent in 2021) and the rest
were treated for “ecstasy” and other drug types.
863. Even though it continues to be a challenge to obtain
accurate data on the prevalence of “captagon” use in the
Middle East, record seizures of this drug in 2021 and various
qualitative data suggest that this substance remained among
the most prevalent drugs used in that subregion.
6. Prevention and treatment
856. Most countries in the region continued to carry out
a wide range of drug treatment and prevention measures in
2022, including policy, institutional and capacity-building
work to improve health-care services, and public campaigns
to raise awareness on drug use involving the governmental
and non-governmental sectors, media and local communi-
ties. However, many countries directly affected by conflict
in the region continue to face challenges with financial and
human resources in order to carry out effective monitor-
ing and reporting on the prevalence of drug use to ensure
the development of evidence-based drug policies for their
populations.
857. Out of an estimated 60 million people who used opi-
oids for non-medical purposes in 2021, representing 1.2 per
cent of the global adult population, half lived in South Asia
or South-West Asia. The Middle East and South-West Asia
remained the subregions with some of the highest levels of
prevalence of opioid use in 2021 (3.19 per cent vis-à-vis a
global average of 1.2 per cent). The main drugs of concern
in South-West Asia are opiates, namely opium and heroin,
while the non-medical use of tramadol continues to pose a
major threat to public health in the Middle East.
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864. There has also been an increase in methamphetamine
use in Afghanistan and in the wider South-West Asia region
in general in recent years.
865. Türkiye continued to face an increasing threat from
methamphetamine use to its population’s health, as traffick-
ing in this substance has increased over the past years and
record seizures of this substance were recorded in 2022. The
share of methamphetamine-related deaths out of all deaths
caused by drugs in Türkiye continued to increase over the
past several years from 6.2 per cent (41 out of 657 substance-
related death cases) in 2018, to 31.2 per cent (98 out of
314 cases) in 2020, to 46.3 per cent (125 out of 270 cases)
in 2021 and finally to 56.9 per cent (140 of 246 cases) in
2022. To address this threat, various drug use prevention
programmes were carried out in 2022, including a project
to increase awareness on harm and deaths caused by meth-
amphetamine as well as the implementation of training
modules for law enforcement in addressing the metham-
phetamine threat in the context of the Methamphetamine
Action Plan launched on 2 August 2022.
drug use. Limited knowledge about the health risks of new
synthetic drugs, particularly the more novel ones when used
in mixtures, has posed significant challenges to the provi-
sion of treatment and services aimed at reducing the nega-
tive health and social consequences of use of such drugs.
Greater support should be provided to law enforcement and
health authorities in monitoring the situation and educating
users on the health risks of polydrug use.
867. The increasing availability and consumption of a
diverse range of cannabis-based products in Europe poses
significant regulatory challenges to authorities in the region.
While most countries have instituted medical cannabis pro-
grammes, some continue to take steps to establish regulated
markets for cannabis for non-medical purposes. Malta has
adopted the National Drug Policy 2023–2033 and hosted
the second ministerial conference with four other European
countries to discuss regulations on the use of cannabis for
non-medical purposes. Luxembourg has passed a bill allow-
ing the home cultivation of cannabis for recreational use,
and Germany has provided further details of their pilot leg-
islative projects for the limited cultivation and distribution
of cannabis for non-medical purposes. The Government of
the Kingdom of the Netherlands has initiated the start-up
phase of its “cannabis experiment” and further pilot trials
have been conducted in Switzerland.
868. In 2021, States members of the European Union
encountered an alarming escalation in illicit drug trafficking
and interdictions. The aggregate seizures of cocaine soared
to an unprecedented level, totalling 303 tons. This marked
increase was particularly evident at smaller European ports.
Additionally, seizures of new psychoactive substances
reached 8.5 tons, with the substances seized being predomi-
nantly synthetic cannabinoids and new synthetic opioids.
This notable upsurge in both the volume and diversity of
illicit drugs represents a significant and evolving challenge
for drug control within the European Union.
869. EMCDDA and the United Nations Office on Drugs and
Crime (UNODC) have noted an increase in the non-medical
use of ketamine across Europe, which has prompted concerns
over potential severe health implications. Belgium, France,
Italy and Spain have reported an increase in the number of
individuals seeking treatment for such use of the substance,
underscoring the need for close monitoring of both usage and
its impact on public health. In 2022, EMCDDA published
data on ketamine detected in wastewater, the highest amounts
being found in cities in Denmark, Italy, Portugal and Spain.
From December 2022 to January 2023, several European
countries participated in INCB Operation Knockout, the aim
of which was to combat illicit manufacturing and distribution
of several substances, including ketamine, which was being
trafficked via various postal and courier services.
E. Europe
The quantity and variety of substances available in illicit
drug markets in Europe pose a considerable public health
concern and create new challenges to law enforcement,
regulation, and the provision of treatment and services to
reduce the negative health and social consequences of
drug use.
Several European countries have continued to establish
regulated markets for cannabis for non-medical purposes.
These programmes do not appear to be consistent with the
drug control conventions.
Several European countries have experienced an increase
in the non-medical use of ketamine, which has led to an
increase in the number of individuals seeking treatment.
This emphasizes the need for close monitoring of ketamine
and continued international collaboration to counter its
illicit distribution.
1.
Major developments
866. Countries in Europe continue to face growing health
risks and concerns because of the rapid emergence of a wider
range of substances and an increasingly complex pattern of
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INCB REPORT 2023
2.
Regional cooperation
870. From December 2022 to January 2023, Belgium,
Bosnia and Herzegovina, Bulgaria, Czechia, Estonia, France,
Germany, Hungary, Iceland, Italy, Latvia, Luxembourg,
Portugal, Spain and the United Kingdom participated in
INCB Operation Knockout. The operation focused on the
exchange of intelligence with the aim of identifying and
dismantling illicit manufacturing and distribution points
involving non-medical carisoprodol, 1,4-butanediol, flu-
bromazepam,
gamma-butyrolactone
and ketamine traf-
ficked through the international post, express mail, courier
services and related modalities.
871. In January 2023, EMCDDA updated its memo-
randum of understanding with the Ministry of Health of
Ukraine. The new arrangement will enable enhanced coop-
eration in the collection, processing, summarizing and analy-
sis of information on the drug and alcohol situation and
will facilitate comparability between the drug data of the
European Union and those of Ukraine.
872. In February 2023, 20 suspected money-launderers
and drug traffickers were arrested in Spain as a result of
a joint investigation supported by Europol. The operation
involved units of the Civil Guard of Spain and the Central
Directorate for Anti-Drug Services of Italy and resulted in
the seizure of more than €5.5 million in criminal assets and
over 2 tons of drugs.
873. In June 2023, INCB Learning held a two-day virtual
workshop focused on raising awareness about the avail-
ability of controlled substances for medical and scientific
purposes as part of the Board’s ongoing efforts to support
Member States in ensuring that essential medicines are
available while preventing their diversion and abuse. The
event brought together officials from the competent national
authorities of seven countries – Armenia, Azerbaijan,
Belarus, Kyrgyzstan, the Russian Federation, Tajikistan
and Uzbekistan – and a diverse group of stakeholders,
which included representatives of palliative care associa-
tions, experts in drug control and public health and mem-
bers of the international community. Over the course of
the two days, participants discussed various themes related
to improving access to controlled substances for medical
purposes, including regulatory frameworks, barriers to
access, and the importance of national and international
cooperation.
874. A total of 171 drug control officials from the com-
petent national authorities of 35 countries in Europe
have registered to use INCB Learning e-modules. INCB
Learning has now developed five e-modules, which cover
narcotic drugs, psychotropic substances, precursors, the
international drug control framework and how to ensure
the adequate availability of controlled substances for medi-
cal and scientific purposes. E-modules are available upon
registration through INCB Learning to officials of compe-
tent national authorities at no cost.
875. In June 2023, the Paris Pact expert working group on
precursors was held in Sofia. Participants from 34 countries
and 10 international and regional bodies joined the event. A
total of 10 recommendations were formulated for review and
endorsement at the seventeenth Policy Consultative Group
meeting to be convened in Vienna on 11 and 12 December
2023.
876. In May 2023, Serbia, in cooperation with Europol
and Belgium, France and Netherlands (Kingdom of the),
dismantled one of the biggest drug trafficking organizations
in the Balkan region. During the operation, a total of 23
individuals were arrested, including the three leaders of the
organization, who were considered high-value targets by
Europol. A total of 15 vehicles and €3 million were seized.
877. In June 2023, Eurojust and Europol supported law
enforcement authorities in Germany, Italy and Netherlands
(Kingdom of the) in the dismantling of an international
drug traffickers’ network. During the operation, 35 suspects
were arrested and €1 million was seized.
878. In June 2023, Europol supported Bosnia and
Herzegovina in identifying and dismantling a large-scale
criminal network involved in the trafficking of drugs and
weapons, money-laundering and corruption. The investiga-
tion focused on the activities of a criminal network involved
mainly in the production and trafficking of drugs in the
Western Balkans, the European Union and South America.
During the operation, 38 suspects were arrested and over
300 kg of cannabis, together with real estate and cash, with
a total combined value of more than €6 million, were seized.
879. In June 2023, the European Council approved the
creation of a new European Union drugs agency. The new
agency, the European Union Drugs Agency, will replace
EMCDDA. The agency’s mandate will be strengthened and
will include such tasks as developing security threat assess-
ments, enhancing cooperation with national focal points
and developing evidence-based interventions.
880. In July 2023, the INCB Global Rapid Interdiction of
Dangerous Substances (GRIDS) Programme participated
in capacity-building training in Budapest for law enforce-
ment officers from police, customs administration and
postal security agencies. The training event was organized
by the United States Drug Enforcement Administration
and focused on enhancing the knowledge and skills
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
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needed to identify and safely interdict dangerous sub-
stances. Participants received instruction on IONICS and
GRIDS Intelligence HD targeting tools to improve global
intelligence-sharing.
3.
Availability of internationally
controlled substances, including
reporting to the Board
881. The three international drug control treaties require
States parties to furnish statistical reports to the Board on an
annual basis. These reports enable the Board to monitor licit
activities involving internationally controlled substances
and assess the level of availability of those substances for
licit medical and scientific purposes.
882. There has been a considerable increase in the
availability of opioid analgesics in Europe over the past
20 years, the level of consumption of opioid analgesics
rising from 73,944 S-DDD per million inhabitants in
2002 to 221,959 S-DDD
pm
in 2021. However, the pattern
is slightly different in various parts of the region. Western
Europe accounted for most of the consumption in 2021
(212,696 S-DDD
pm
, or 95 per cent of the total). Austria,
Belgium, Germany, Gibraltar, Iceland, Spain, Netherlands
(Kingdom of the) and Switzerland all reported consumption
above 10,000 S-DDD
pm
. Consumption in South-Eastern
Europe increased from 2,056 S-DDD
pm
in 2002 to 8,410 in
2021. Croatia, Montenegro, Romania and Serbia reported
a consumption level of 1,000 S-DDD
pm
. Eastern Europe
also experienced an increase, albeit a smaller one (from
344 S-DDD
pm
in 2002 to 851 S-DDD
pm
in 2021). Among
the various opioids, fentanyl was the most commonly con-
sumed in 2021 (156,159 S-DDD
pm
), followed by oxycodone
(26,478 S-DDD
pm
) and morphine (21,372 S-DDD
pm
).
883. Adopted in 2011, Commission on Narcotic Drugs
resolution 54/6 encourages Member States to report con-
sumption of psychotropic substances to the Board. Although
some European countries have consistently reported such
consumption over the past 10 years, the proportion of
European countries doing so decreased from 41 per cent
in 2011 to 32.5 per cent in 2021.
884. As regards precursor chemicals, Member States vol-
untarily provide estimates of their annual legitimate require-
ments for imports of certain precursor chemicals frequently
used in the illicit manufacture of amphetamine-type stimu-
lants in the context of resolution 49/3 of the Commission on
Narcotic Drugs. Among other substances, the provision of
annual legitimate requirements is requested for ephedrine
and pseudoephedrine, substances that also have medicinal
uses, and, to the extent possible, for preparations contain-
ing those substances that could be easily used or recovered
by readily applicable means. As at 1 November 2023, of
the 45 countries on the European continent, 40 (89 per
cent) had provided at least one estimate of annual legiti-
mate requirements for the import of ephedrine, ephedrine
preparations, pseudoephedrine or pseudoephedrine prepa-
rations to the Board. However, two (or approximately 5 per
cent) of them have not updated their estimates in the past
10 years, which undermines the potential of annual legiti-
mate requirements as a tool to guide exporting countries on
the legitimate requirements of importing countries and thus
prevent the oversupply and diversion of such substances
into illicit channels, as well as ensuring their availability for
legitimate purposes.
885. Further information on the availability of interna-
tionally controlled substances can be found in the tech-
nical reports of the Board for 2023 on narcotic drugs,
164
psychotropic substances
165
and the implementation of article
12 of the 1988 Convention.
166
In addition, the publication
entitled
Guide on Estimating Requirements for Substances
under International Control,
developed by INCB and WHO
for use by competent national authorities, and the docu-
ment entitled “Issues that Governments may consider when
determining annual legitimate requirements for imports
of ephedrine and pseudoephedrine” are available on the
Board’s website.
4. National legislation, policy and
action
886. In December 2022, the Pompidou Group adopted
a new work programme for 2023–2025, establishing four
priorities, namely: (i) promoting sustainable drug and
addiction policies in conformity with human rights prin-
ciples; (ii) safeguarding democratic societies by addressing
addictions that impact human autonomy; (iii) protecting the
rights of persons belonging to vulnerable and risk groups
with drug use and addiction problems; and (iv) reducing
the availability of illicit drugs and preventing the diversion
of precursors. The new programme sets out relevant action
items relating to each priority, and the expected results are
to be delivered and acted on according to set timelines for
each activity.
887. Several European countries have placed the can-
nabinoid hexahydrocannabinol (HHC) and its derivatives
under national control owing to its increasing availability
164
165
166
E/INCB/2023/2.
E/INCB/2023/3.
E/INCB/2023/4.
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INCB REPORT 2023
in Western Europe and the severe health impact associated
with its use. Since 13 June 2023, the production, sale and
use of HHC, HHC-acetate (HHCO) and hexahydroxycan-
nabiphorol (HHCP) have been prohibited in France. Similar
measures have been implemented in other countries, includ-
ing Belgium, Cyprus and Sweden.
888. Albania adopted a law to regulate the production of
cannabis for medicinal and industrial purposes in July 2023.
Under the proposed legislation, all cultivation and produc-
tion of, and trade in, cannabis for medicinal and industrial
purposes would be for export only, and a national agency
for the control and monitoring of those activities would be
established. There would be no limit on the THC content
of cannabis for medicinal purposes, while the maximum
permitted THC content of cannabis for industrial purposes
would be 0.8 per cent.
889. In June 2023, Malta adopted the National Drug Policy
2023–2033, aimed at reducing the demand and the supply of
illicit drugs in the country. In September 2023, the country
also hosted its second ministerial conference with four other
European countries (Czechia, Germany, Luxembourg and
Netherlands (Kingdom of the)) to discuss developments
related to regulations and laws regarding the use of cannabis
for non-medical or non-scientific purpose.
890. The Government of Luxembourg passed a bill allow-
ing the home cultivation and possession of cannabis for
non-medical purposes in June 2023. Under the new law,
adults will be allowed to grow up to four cannabis plants
per household for private non-medical use provided that
the cultivation is not visible from the outside.
891. In April 2023, the Government of Czechia approved
the Addiction Policy Action Plan for 2023–2025. The action
plan establishes five priority areas: prevention and treat-
ment of addiction; regulated market for substances with
addictive potential; tax collection according to the level of
risk of products with addictive potential; promotion of a
balanced addiction policy; and minimization of the impact
of the crisis in Ukraine on the national addiction situa-
tion. One of the specific activities to be carried out under
this plan is to develop a model for the regulated market of
cannabis for non-medical use and submit it for discussion
in the country.
892. Following an announcement in 2022 relating to the
use of cannabis for non-medicinal purposes in Germany, the
Government of that country approved a draft law regulating
the availability of the substance in August 2023. The law will
be implemented on the basis of two pillars, the first of which
enables private cultivation by adults for their own consump-
tion, as well as communal, non-commercial cultivation by
non-profit associations, or “social clubs”, of up to 500 mem-
bers. Private cultivation will be limited to three plants and
individuals may have less than 25 grams in their possession
in public. The second pillar will allow the distribution of
cannabis in specialist shops in specific regions for a limited
duration. The effects of a commercial cannabis supply chain
on health and youth protection in the relevant pilot projects
will be investigated and evaluated. The draft law on the first
pillar is expected to enter into force at the end of 2023.
893. In February 2023, the Kingdom of the Netherlands
announced its decision to initiate the start-up phase of
its “cannabis experiment” following its enactment of the
Controlled Cannabis Supply Chain Experiment Bill in July
2020 and the subsequent preparatory phase of the experi-
ment. During the start-up phase, which is expected to
begin in December 2023, cannabis growers in the munici-
palities of Tilburg and Breda will be able to deliver canna-
bis to coffee shops on a small scale. The start-up phase is
restricted to participating municipalities, a trading stock of
500 grams of regulated products and a maximum duration
of six months.
894. Pilot trials involving the controlled distribution of
cannabis for non-medicinal purposes have been authorized
in Switzerland following the amendment of the country’s
drug legislation in 2021. The trials are being conducted by
the cantonal and communal authorities, not at the federal
level, and the non-medical use of cannabis other than for
the purposes of the pilot trials remains prohibited by the
Narcotics Act. As at June 2023, pilot trials in five major
cities (Basel, Bern, Geneva, Lausanne and Zurich) had been
authorized and cannabis for non-medicinal purposes was
to be distributed in pharmacies, cannabis social clubs and
non-profit stores and through other channels. The evalua-
tion results of the pilot trials are not expected until 2024.
895.
The Board wishes to remind all parties to the
1961 Convention as amended that, under article 4, para-
graph (c), thereof, the parties are required to take such
legislative and administrative measures as may be neces-
sary, subject to the provisions of the Convention, to limit
exclusively to medical and scientific purposes the produc-
tion, manufacture, export, import, distribution of, trade
in, use and possession of drugs.
896. Switzerland amended its regulations concerning the
prescription of diacetylmorphine in April 2023, taking into
account the special needs of older, less mobile patients with
comorbidities. The amendment provided for the possibil-
ity of delegating the administration of diacetylmorphine to
appropriate external institutions such as pharmacies, and of
providing patients with several take-home doses for treat-
ment in specific, strictly supervised cases.
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897. The Kingdom of the Netherlands amended its Opium
Act to put nitrous oxide under national control, in response
to the adverse health impact associated with its use and as
recommended by the Coordination Centre for Assessment
and Monitoring of New Drugs. Since 1 January 2023, the pro-
duction and possession of and trade in nitrous oxide has been
restricted for the food industry and for medical purposes.
898. In February 2023, the Parliament of Croatia adopted
a new national strategy on addiction policies. The new
strategy defines priorities, special goals and measures with
respect to addictions and behavioural addictions (to alcohol,
tobacco, drugs, gambling or betting and use of the Internet
and social networks), and is aimed at reducing demand for
and the availability of illegal substances in the country by
2023. The strategy will be implemented through two opera-
tional action plans.
899. In March 2023, France adopted an interministe-
rial strategy for mobilization against addictive behaviour
for the period 2023–2027, which is aimed at treating all
addictive behaviour as an overarching problem. Under that
framework, prevention and education are a priority in pro-
viding everyone with the scientific knowledge and psycho-
social skills to avoid drugs and other addictive behaviour.
Measures to prevent addictive behaviours in different social
establishments will be stepped up and integrated into service
projects.
900. In May 2023, the Parliament of Lithuania adopted a
national agenda on drug, tobacco and alcohol control, con-
sumption prevention and harm reduction. Aimed at estab-
lishing the objectives, areas of focus and impact indicators of
a long-term policy, the national agenda focuses on reducing
demand for and supply of drugs, tobacco and alcohol and
harm to the individual, society and the State.
901. Slovakia is currently rolling out a new drug strategy
for the period up to 2030. One of the pillars of the strategy
is increased national and international cooperation. Several
ministries will be cooperating to achieve common goals,
while the Slovak Police Force will focus on the detection of
organized groups at both national and international levels.
The detection of laboratories manufacturing new psycho-
active substances, the detection of cross-border crime and
prioritization of the protection of entry points into the coun-
try will be key tasks for the police force.
902. In December 2022, Montenegro enacted a rule
book on methods of drug disposal and keeping records
of drugs that have been seized and disposed of. The rule
book was published in the Official Gazette of Montenegro,
No. 132/2022 of 5 December 2022, and entered into force
on 13 December 2022.
5.
Cultivation, production,
manufacture and trafficking
903. According to the EMCDDA European Drug Report
for 2023, the scale of complexity of illicit drug manufacture
in Europe continues to grow. In 2021, a total of 434 syn-
thetic drug manufacturing laboratories were dismantled in
the European Union. Some of those production sites were
large-scale facilities. Capacity for synthetic drug production
is high in general, and production processes are increas-
ingly diversified, as evidenced by the recent seizure of pre-
precursors used to manufacture the precursor chemicals
needed to produce amphetamine, methamphetamine and
MDMA, thus circumventing existing controls.
904. In October 2023 the Spanish National Police and the
Tax Agency reported dismantling in Barcelona a clandestine
laboratory that had been producing dangerous new psycho-
active substances, using information provided through the
INCB GRIDS programme. Three people have been arrested,
and materials for the production of more than 7,500,000
doses of new psychoactive substances, such as the stimu-
lant known as “monkey powder”, the synthetic cannabinoid
ADB-BUTINACA and the synthetic cathinone
alpha-PiHP,
have been seized. These synthetic drugs were shipped world-
wide, including to Europe, North America and Oceania by
parcel post.
905. In 2021, the number of dismantled clandestine
laboratories producing cocaine and methamphetamine
increased in European Union countries. Illicit manu-
facture of amphetamine remained stable, while the detec-
tion of MDMA manufacturing sites decreased by a quarter,
most likely reflecting the shift to the production of other
substances.
906. A total of 12 European Union member States
reported the dismantling of a total of 261 methamphetamine
laboratories in 2021 – an increase of 23 per cent in com-
parison with 2020 (when 213 laboratories were dismantled).
Those laboratories included various medium- and large-
scale facilities in the Kingdom of the Netherlands (15) and
Belgium (9). Small- to medium-scale methamphetamine
manufacturing sites were dismantled in Czechia (188).
907. A total of 723 kg of ephedrine and pseudoephedrine
(tablets and powder) were seized in 15 European Union
countries. In comparison, 955 kg were seized in 2021 (a
decrease of 24 per cent compared with 2020) in 12 countries
(an increase of 25 per cent, compared with the 8 countries
where such seizures were effected in 2020). Additionally,
5,100 litres of BMK, 9.7 tons of MAPA (used to make P-2-P)
and 4.5 tons of MAMDPA (used to make 3,4-MDP-2-P)
were seized in the European Union in 2021.
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INCB REPORT 2023
908. A record amount of 303 tons of cocaine was seized
by European Union member States over the course of 2021.
Belgium (96 tons), Netherlands (Kingdom of the) (72 tons)
and Spain (49 tons) accounted for three quarters of all the
cocaine seized. Seizures in the second-biggest European port
(Antwerp) rose from 91 tons in 2021 to 110 tons in 2022. The
recent trend is that increasingly smaller ports throughout
Europe are being targeted. In the United Kingdom, cocaine
seizures by police and border forces increased by 68 per cent,
from 11,141 kg in the year ending March 2021 to 18,767 kg
in the latest year (fiscal year ending March 2022), the high-
est seized quantities on record. This was due to an increase
in the number of seizures of 100 kg or more by the United
Kingdom Border Force.
909. The unprecedented expansion of the global cocaine
market has followed significant changes in both source and
destination markets. Around 2012, the increasing involve-
ment of groups from the Balkan region, which directly
procure cocaine from Latin America, increased competi-
tion among traffickers supplying markets in Western and
Central Europe, the second largest destination market for
the drug, triggering improvements in the efficiency of the
supply chain, increasing purity and lowering prices and
paving the way for a steady increase in consumption.
910. Cannabis remained the most frequently seized drug
in European Union member States in 2021. Member States
of the European Union recorded a total of 202,000 seizures
comprising 816 tons of cannabis resin, marking an increase
from 588 tons in 2020. Concurrently, there were 240,000
incidents involving the confiscation of cannabis herb, the
total amount of which was 256 tons, in contrast to 157 tons
in the previous year. Separately, Türkiye accounted for 9,800
seizures (33 tons) of cannabis resin and 52,500 seizures
(31 tons) of cannabis herb.
911. According to Italian authorities, since 2020, Italian
ports, mainly the southern port of Gioia Tauro, have been
increasingly used as trans-shipment points for cocaine being
trafficked eastward to ports on the Aegean Sea and the Black
Sea. At those ports, large shipments of cocaine from South
America are received by Balkan criminal groups, who
ensure its wholesale distribution and transportation to mar-
kets and stockpiling areas in Greece, Bulgaria, Romania and
(prior to the armed conflict) Ukraine. Significant develop-
ments have also been observed in Türkiye, where seizures
almost quadrupled between 2014 and 2017 (from 393 kg to
1,485 kg), and Romania, where the number of cocaine sei-
zures – likely reflecting the domestic retail market – began
to increase in 2015, a similar increase in Bulgaria beginning
two years later.
912. In May 2022, EMCDDA released its annual waste-
water analysis publication. The publication included data
from 104 cities and pointed at distinct geographical patterns
of use across different European cities. Usage of cocaine
remains high in cities located in western and southern
Europe, in particular Belgium, Netherlands (Kingdom
of the), Portugal and Spain. Detection of amphetamine
in wastewater showed that that substance was found at a
much lower level in cities in the south of Europe, although
an increase was observed. At the same time, the highest
quantities were detected in northern European countries
(Belgium, Finland, Germany, Netherlands (Kingdom of the)
and Sweden). Methamphetamine traces were more concen-
trated in regions where the substance has been previously
encountered (Belgium, Czechia, eastern Germany, Slovakia,
Spain and Türkiye). While the presence of methamphet-
amine remains very low in other regions, an increase in
southern and central European countries has been observed.
The highest occurrences of MDMA were found in Belgium,
Netherlands (Kingdom of the), Spain and Portugal. For the
first time ever, data related to ketamine were published and
the highest occurrences were observed in cities in Denmark,
Italy, Spain and Portugal.
913. In July 2023, the police of Germany seized around
300 kg of amphetamine and dismantled the biggest drug
laboratory for the manufacture of counterfeit “capta-
gon” tablets in German history. In addition to 300 kg of
the active ingredient, 2.5 tons of cutting agents, a tablet-
making machine and several pairs of punches with the
“captagon” logo were seized. In a joint report, the police
of Germany and EMCDDA examined the role of Europe
in “captagon” trafficking. The report highlighted that while
the overall quantity of amphetamine seized in the European
Union was relatively stable, large amounts of “captagon”
tablets were seized in the European Union in transit to the
Arabian Peninsula. Türkiye seized more amphetamine than
the entire European Union in 2017 and 2018 as a result of
large seizures of “captagon” tablets (6.6 tons and 5.7 tons,
respectively). According to the report, there may be a con-
nection between the decrease in seizures in Türkiye and the
increase in seizures in the European Union, probably owing
to a change in trafficking routes.
914. In 2021, a record 8.5 tons of new psychoactive sub-
stances were seized by European Union member States.
The substances reported include synthetic cannabinoids,
hexahydrocannabinol, synthetic cathinones, new synthetic
opioids and benzimidazole opioids. Half of the substances
reported by the European Union early warning system were
synthetic cannabinoids (24), representing an increase of
60 per cent compared with 2020, when 15 new synthetic
cannabinoids were detected. The increased diversity is likely
owed to illicit drug producers’ attempts to circumvent the
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2021 class-wide ban on synthetic cannabinoids imposed by
China. National estimates of the use of new psychoactive
substances (excluding ketamine) among young adults (aged
15 to 34) range from 0.1 per cent in Latvia to 5.1 per cent in
Romania. At the end of 2022, EMCDDA was monitoring a
total of 930 new psychoactive substances, 41 of which were
reported for the first time in Europe in 2022.
915. Since 2009, 74 new opioids have been identified on
the European drug market. However, in 2022 only one new
opioid was identified. Preliminary data for 2023 suggest that
benzimidazole opioids are increasingly being detected in
Latvia, while Estonian police also reported seizing multi-
ple mixtures containing metonitazene mixed with broma-
zolam and the animal tranquillizer xylazine. Metonitazene
has been added to Schedule I of the 1961 Convention as
amended, while bromazolam and xylazine are not currently
under international control.
916. Cyprus reported that in 2022, a total of 1,017 cases
relating to illegal addictive substances – involving 1,084
people – had been recorded, including 136 instances involv-
ing cannabis plants, 166 instances involving MDMA pills,
and the seizure of approximately 348 kg of cannabis herb,
39 kg of cannabis resin, 38 kg of cocaine, 1.5 kg of synthetic
drugs, 3.5 kg of MDMA and 4.4 kg of methamphetamine.
917. Estonia reported that the number of drug-related
fatalities related to fentanyl-like synthetic opioids or ben-
zimidazoles rose sharply in 2022. While those substances
are still trafficked mainly by land using vehicles, including
trucks, or by post, in some instances trafficking using drones
was observed. Large-scale trafficking in Estonia seems to be
linked to the sale by vendors of multiple substances, using
legal business structures, and money-laundering networks.
Encrypted social media platforms are increasingly being
used for the sale of such substances.
918. The Russian Federation reported that in 2022, law
enforcement agencies recorded over 177,000 crimes related
to illegal drugs. Of that total, 110,895 crimes were related to
the trafficking of those substances and 829 involved seizures
related to the manufacture of drugs. Additionally, 82,800
websites and links to resources containing information on
drug trafficking were blocked.
of prevention, drug identification and treatment services.
According to EMCDDA, coverage of and access to treatment
and services to reduce the negative health and social conse-
quences of drug use remain uneven both within and between
countries, and in some cases fall short of countries’ needs.
920. An increasingly complex pattern of polydrug use,
together with the expanded availability of synthetic opioids
and synthetic stimulants, emphasizes the need to review the
distribution and administration of the opioid antagonist
naloxone and to develop more effective responses to reduce
drug overdose deaths and drug-related poisonings.
921. According to the European Drug Report 2023, canna-
bis remains the most commonly used substance in Europe,
some 22.6 million adults (8 per cent of adults) reporting its
use in 2021. The second most commonly used substance
is cocaine, approximately 3.7 million adults (1.3 per cent
of adults) reporting its use in the past year. Heroin use
remained stable, around 1 million people (0.3 per cent of
adults) reporting use of the substance in 2021.
922. Data from the 2022 Crime Survey for England and
Wales suggest a similar drug use pattern, cannabis being
reported as the most commonly used drug in England and
Wales. In 2022, about 7 per cent of adults reported having
used cannabis in the past year, a further 2 per cent reporting
having used powder cocaine. Prevalence of “ecstasy” use
dropped to its lowest level (0.7 per cent) in 2022, which may
be the result of government restrictions on social contact
during the COVID-19 pandemic.
923. The Russian Federation reported that as at 1 January
2023, the number of patients receiving treatment for drug
use disorders remained at the same level as the previous year
(229,700), of the 391,700 patients registered in specialized
medical institutions of the Ministry of Health. The number
of people who use drugs who registered in such institutions
for the first time totalled 14,000.
924. Similarly, the World Drug Report 2023 suggests that
opioids are the most common primary drugs of misuse
among people in drug treatment in most of Europe. Among
the different subregions, Eastern Europe continues to have
the highest estimated prevalence rate of people who inject
drugs (1.3 per cent of the adult population) and the high-
est prevalence of HIV among people who inject drugs in
Europe (25.4 per cent).
925. According to UNODC, Ukraine is among the coun-
tries with the highest prevalence rates of people who inject
drugs and are living with HIV. During the period 2018–2020,
there were around 350,000 people who inject drugs in the
country (1.17 per cent of the adult population). The opioids
6. Prevention and treatment
919. While most European countries have rigorous sys-
tems for the collection of the latest prevalence and treatment
data, the increasing number of new substances, together with
increasingly complex patterns of polydrug use, has posed
significant challenges to authorities in terms of the provision
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INCB REPORT 2023
injected include heroin and methadone sourced from illicit
markets. An estimated 20.3 per cent of people who inject
drugs are living with HIV and more than half are living with
hepatitis C. Disruption of basic services in the country since
the beginning of the current crisis in 2022 suggests that chal-
lenges are faced by people who use drugs in receiving timely
HIV diagnosis and uninterrupted antiretroviral treatment.
926. While all European Union member States and Norway
have needle and syringe programmes, coverage and access
to those programmes remains a challenge. Only 5 of the 17
countries with available data reached WHO service provision
targets in 2021. Opioid agonist treatment is implemented in
all European countries and has been recognized as crucial in
mitigating overdose deaths. Methadone is the most widely
used agonist, 56 per cent of clients receiving that substance,
while 35 per cent receive buprenorphine-based medica-
tions. In view of the health risks caused by an increasing
number of illicit drugs, a considerable number of countries
also reported the implementation of drug identification ser-
vices, take-home naloxone programmes and supervised drug
consumption rooms.
927. The latest data available to EMCDDA suggests that
cannabis use was the main reason for first-time specialized
treatment. An estimated 55,000 cannabis users received
their first treatment in 2021, accounting for 45 per cent of
new cases. Most cannabis users receiving treatment were
male, with an average age of 26. While the total number
of first-time treatment recipients decreased slightly when
compared with the level before the COVID-19 pandemic,
a recent EMCDDA review revealed an increase in the avail-
ability of treatment options, some of which are delivered
through telemedicine or digital applications.
928. With an estimated 25,000 first-time treatment recipi-
ents in 2021, cocaine was the second main drug of use among
first-time treatment recipients within the European Union.
Available mostly as cocaine powder, but sometimes also as
“crack” cocaine, it accounted for 27 per cent of acute poison-
ing cases in hospital emergency room incidents and was the
substance most commonly associated with such conditions.
Most cocaine users receiving treatment were male users with
an average age of 33. An estimated 7,500 “crack” users began
treatment in 2021, which indicates the expansion of the use
of that substance within marginalized groups.
929. The number of drug-induced deaths in the European
Union increased slightly in 2021, reaching more than
6,000 (around 5,800 in 2020), mainly because of new data
reported by Germany. While opioids, including heroin
and its metabolites, often used in combination with other
substances, are associated mainly with overdose deaths, an
increasing number of deaths in the Baltic countries were
due to polydrug use involving synthetic opioids such as
benzimidazoles and fentanyl derivatives. Furthermore,
a considerable increase in overdose deaths has also been
observed among older drug users (50 to 64-year-olds).
The growing emergence of new synthetic opioids and their
adverse health impact call for more targeted prevention and
treatment services.
930. Both UNODC and EMCDDA have highlighted an
increase in the non-medical use of ketamine in Europe in
recent years. Ketamine is included in the WHO Model List
of Essential Medicines. It is used in human and veterinary
medicine mainly as an anaesthetic but also for the treatment
of short-term, acute pain. However, it is also commonly
misused, either by snorting or by injection. Sometimes it
is also found added to other drugs. The long-term use of
ketamine can cause severe health problems. Since some
European countries (Belgium, France, Italy and Spain) have
reported a recent increase in the number of people receiving
treatment for the non-medical use of ketamine, its use and
health impact should be closely monitored.
931. A special report released by EMCDDA draws atten-
tion to the use of nitrous oxide as a growing concern for
Europe, especially among young people. As the substance
has become more accessible and cheaper over the past few
years, its popularity has grown, partly also because of a gen-
eral perception that the health risks associated with its use
are low. Cases of poisonings, burns and lung injuries have
been reported in some countries, and prolonged use of the
substance can result in nerve damage. Much greater atten-
tion should thus be given to this substance in drug preven-
tion and treatment programmes.
932. A growing interest in the therapeutical potential of
psychedelic drugs and the potential risks in their unregu-
lated use has also been noted. While clinical studies on the
use of psychedelics are conducted in some countries, most
of the health, wellness and tourism businesses involving
the use of psychedelics have been operating without much
regulatory oversight. Unsupervised and experimental use
of those substances, even in microdoses as self-medication,
may put some vulnerable populations at risk.
933. The latest national reports on health behaviour in
school-aged children provide updates on drug use patterns
among young people in some European countries (Austria,
Greece, Greenland, Finland, Italy and Scotland). Cannabis
remained the most popular drug among 15-year-olds in 2021
and 2022; Sweden reported increasing cannabis use among
boys, and Austria recorded increasing use among girls.
934. In the United Kingdom, recent surveys among sec-
ondary school pupils reveal a decrease in the prevalence
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125
of lifetime and recent illicit drug use, the proportion of
pupils who reported taking any drug falling from 24 per
cent (2018) to 18 per cent (2021). There was a similar trend
among those who reported taking any drug in the past year,
the proportion of such individuals decreasing from 17 per
cent (2018) to 12 per cent (2021).
935. In Estonia, studies on syringe residues from used
syringes have been conducted since 2021 as part of the
provision of treatment and services to reduce the nega-
tive health and social consequences of drug use, enabling a
better understanding of the use of injectable drugs in differ-
ent regions and locations where treatment and services are
provided. In 2022, more than half of the syringes contained
amphetamine (66 per cent), followed by methamphetamine
(28 per cent) and other substances. Isotonitazene and other
synthetic opioids such as fentanyl, furanylfentanyl and car-
fentanil were also found.
transnational criminal activity expected with the reopening
of borders across the region. The import, trans-shipment,
sale and possession of drugs, together with precursor
trafficking, were the most prevalent transnational crimi-
nal activities in the region. While Pacific island States had
mainly been affected as transit points in the past, domestic
illicit drug markets had grown across the region over the
past 10 years, leading to increases in drug use disorders and
mental health issues. Some countries also reported increases
in crimes related to drug trafficking, such as burglary, vio-
lence, intimidation and extortion, and, in larger countries,
increasing use of firearms. In countries such as Fiji, Kiribati,
New Zealand and Tonga, non-medical drug use had been
observed to harm families, with an increased risk of sexual
violence, child neglect, and poor health, educational and
employment outcomes. The report also noted that a causal
relationship between illicit drug use and child labour had
been identified in Kiribati.
937. The Pacific Islands Forum
Second Quadrennial Pacific
Sustainable Development Report 2022
noted that only four
167
of the Forum’s member States were party to all three inter-
national drug control conventions and that, as a result,
drug-related legislation across some Pacific island States
was outdated and ill-equipped to address emerging issues.
The region faced rising levels of crime and drug misuse and,
despite commitments made by Pacific island States to address
trafficking and transnational crime, there continued to be
a lack of information on drug trafficking. However, efforts
were under way among regional customs and law enforce-
ment bodies, such as the Oceania Customs Organization and
the Pacific Islands Chiefs of Police, to enhance data collection
on and analysis of transnational crime.
938. In previous reports, the Board has highlighted that
non-parties to the international drug control conventions
are concentrated in Oceania, which remains highly vulner-
able to drug and precursor trafficking in view of its extensive
maritime borders.
INCB reiterates its call upon non-parties
to take steps towards accession to, and full implemen-
tation of, the international drug control conventions to
facilitate action against the drug problem in all its forms.
The Board also encourages regional and bilateral partners
to support countries in the region to this end, with a view
to ensuring that these States can benefit from the imple-
mentation of the conventions, in particular in improving
the availability of internationally controlled substances
for medical purposes, preventing and addressing drug
trafficking, strengthening international cooperation in
criminal matters and providing evidence-based preven-
tion, treatment and rehabilitation services.
F.
Oceania
Pacific island States have confirmed the transformation
of their countries from solely transit sites along drug
trafficking routes to destination markets for synthetic
drugs, posing significant challenges to communities and
their public health systems. Law enforcement and cus-
toms agencies of these countries reported multiple drug
seizures, particularly of cannabis and methamphetamine.
Transnational organized crime, especially drug trafficking,
has been recognized as one of the most challenging issues
facing the Pacific region.
Transnational organized criminal groups were attempting
to traffic unprecedented amounts of cocaine to Australia,
although the methamphetamine market remained the pre-
dominant illicit drug market. Law enforcement authorities
highlighted the need to address organized crime and vio-
lence related to trafficking in large quantities of drugs to
the region.
1.
Major developments
936. The Pacific Islands Forum “Pacific security outlook
report 2022–2023” highlights transnational organized crime
as one of the region’s priority focus areas. The report noted
that transnational organized criminal groups had adapted
to COVID-19-related border closures, resulting in increased
channels and platforms for illicit activity, with a surge in
167
Fiji, Marshall Islands, Micronesia (Federated States of) and Tonga.
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INCB REPORT 2023
939. Although the methamphetamine market remained
the largest illicit stimulant market in Australia, transnational
organized criminal groups were attempting to traffic unprec-
edented amounts of cocaine to Australia. Wastewater analy-
sis found that over the 12-month period from September
2021 to August 2022, at least 3.3 tons of cocaine were con-
sumed in Australia; less than the 5.6 tons consumed in the
12-month period ending in August 2020. In 2022 and 2023,
large seizures of cocaine were made in Oceania.
940. In 2023, UNODC launched a new transnational
organized crime programme based in Fiji and aimed at
supporting Pacific island States in addressing cybercrime,
money-laundering, environmental crime and trafficking.
drugs. The GRIDS Programme delivered an awareness-
raising and capacity-building workshop on the safe inter-
diction of synthetic opioids and related chemicals and on the
interregional and intraregional exchange of intelligence and
cross-border cooperation for 19 senior customs and postal
security officers. The training focused on capacity-building
to enhance communications among the authorities of the
Northern Pacific subregion concerning safe handling and
interdiction approaches for dangerous substances.
944. From December 2022 to January 2023, the authori-
ties of Australia, Fiji, Kiribati, Micronesia (Federated States
of), New Zealand, the Northern Mariana Islands, Solomon
Islands and Tonga participated in the GRIDS Programme’s
Operation Knockout, aimed at identifying and disman-
tling illicit manufacturing and distribution points for non-
medical carisoprodol, 1,4-butanediol, flubromazepam, GBL
and ketamine trafficked through the international post,
express mail, courier services and related modalities.
945. From 20 to 31 March 2023, the Oceania Customs
Organization held a two-week workshop in Tonga, with
the support of INCB, the Universal Postal Union, the
Australian Border Force and the United States Postal
Inspection Service. Customs officers from the Cook Islands,
Fiji, French Polynesia, Kiribati, New Caledonia, Niue,
Papua New Guinea, Samoa, Solomon Islands, Tonga and
Vanuatu attended the workshop, which focused on small
craft intelligence, including the use of the Oceania Customs
Organization Pacific Small Craft mobile application. The
application was now used by more than 300 officials, who
had recorded over 2,000 movements leading to the appre-
hension of 1,200 vessels. During the second week of the
workshop, training on postal inspection and the use of intel-
ligence-gathering tools was led by the GRIDS Programme
for 32 enforcement officers from police, customs and postal
security authorities from 14 countries and territories in the
South Pacific subregion. Subsequent training was held by the
GRIDS Programme for the authorities of Samoa on 4 April
2023. Both INCB training activities followed a practical cur-
riculum covering the safe identification and interdiction of
dangerous substances. Participants also received instruction
on the IONICS and GRIDS Intelligence high-definition tar-
geting tools to improve cross-border intelligence-sharing.
946. In March 2023, UNODC held regional multi-agency
training on cryptocurrencies and darknet investigations in
Nadi. The training focused on the new Internet-based tech-
nologies being exploited to facilitate trafficking in opioids
and synthetic drugs.
947. In May 2023, the UNODC Global Maritime Crime
Programme, in partnership with the United States Navy,
held a one-week training activity on maritime crime scene
2.
Regional cooperation
941. Security leaders from 25 countries attended the fourth
meeting of the Joint Heads of Pacific Security in Nadi, Fiji, in
November 2022. The participants agreed to establish a part-
nership for the sharing of information to enhance regional
maritime security, with a view to mitigating the security
issues faced by Pacific island States as a result of climate
change, illegal fishing, drug trafficking and other threats.
942. In November 2022, a UNODC regional workshop on
synthetic drugs was held in Nadi with the participation of
law enforcement, public health and forensic experts from
Fiji, Samoa, Solomon Islands, Tonga and Vanuatu. At the
workshop, participants confirmed that their countries had
become destinations for synthetic drugs, in addition to
being points of transit for drug trafficking between East and
South-East Asia and the Americas. Cannabis remained a
major concern in the region, but several countries, including
Fiji, Samoa and Tonga, reported that methamphetamine had
now become the primary drug of concern and was causing a
strain on public health systems. The lack of drug-related data
within the region and its implications were acknowledged by
participants, as was limited forensic testing capacity.
943. From 28 November to 9 December 2022, the Oceania
Customs Organization, in partnership with INCB, the
Universal Postal Union, the Australian Border Force and
the United States Postal Inspection Service, held a two-
week training activity in Hagatna, Guam, for the Northern
Pacific subregion. The first week of training focused on the
use of the Oceania Customs Organization Pacific Small Craft
mobile application and All Partners Access Network tech-
nology, which provide a secure platform for the exchange of
information. The second week focused on the detection and
interdiction of suspicious parcels arriving through air freight,
courier and post, focusing on new psychoactive substances,
opioids and fentanyl-type substances, as well as controlled
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Chapter III. analysIs of the world sItuatIon
127
management for the Maritime Police, Navy and Customs
Enforcement Division of Fiji in Suva. Building upon virtual
training conducted in 2021 and 2022 for participants from
Fiji, Kiribati, Samoa, Tonga and Vanuatu, the activity was
aimed at creating a more secure maritime environment by
countering illicit activities such as drug trafficking, human
trafficking and illegal fishing.
948. The first Transnational Serious Organized Crime
Global Summit was held in Sydney in June 2023 and was
attended by senior law enforcement officers from 46 coun-
tries. The event focused on partnerships for disrupting the
illicit drug trade and addressing transnational crime.
949. The GRIDS Programme organized the sixth annual
operational meeting on countering trafficking in dangerous
synthetic drugs and chemicals through postal, courier and
air cargo services, held in Vienna from 11 to 15 September
2023. The event brought together over 100 officers from
30 Governments and international organizations, includ-
ing three participants from Fiji and the Oceania Customs
Organization. Several participating Governments also con-
ducted bilateral and multilateral case meetings to enhance
cooperation across borders, facilitated by INCB.
950. From 18 to 22 September 2023, the GRIDS
Programme held a twinning event in Nadi for Pacific island
States on regional law enforcement cooperation, trust-
building, relationship development and active networking,
awareness of opioids, fentanyl-related substances and new
psychoactive substances, and access to and training on intel-
ligence development (GRIDS Intelligence high-definition)
and secure real-time trafficking communications (IONICS).
951. Customs and law enforcement officers of the region
completed training on the detection and prevention of trans-
national crimes in the Pacific by the Australia Pacific Security
College in Nadi in May 2023. Oceania Customs Organization
participants were from the Cook Islands, Fiji, Micronesia
(Federated States of), Samoa and Solomon Islands. In 2023,
the Australian Federal Police provided forensic and crime scene
training for members of the Royal Solomon Islands Police
Force on, inter alia, drug seizure and preliminary drug testing.
952. A total of 26 drug control officials from the competent
national authorities of nine countries in Oceania, namely,
Australia, the Cook Islands, Fiji, Kiribati, New Zealand,
Papua New Guinea, Solomon Islands, Tonga and Vanuatu,
have registered to use INCB Learning e-modules. There are
now five e-modules developed by INCB Learning, which
cover narcotic drugs, psychotropic substances, precursors,
the international drug control framework and ensuring the
adequate availability of controlled substances for medical
and scientific purposes. The e-modules are available upon
registration through INCB Learning to officials of compe-
tent national authorities at no cost. At the global level, as
at 1 November 2023, 1,462 officials from the competent
national authorities of 154 countries and territories had
been granted access to INCB Learning e-modules.
3.
Availability of internationally
controlled substances, including
reporting to the Board
953. The three international drug control treaties require
States parties to furnish statistical reports to the Board on an
annual basis. These reports enable the Board to monitor the
licit movement of internationally controlled substances, as
well as ensure the availability of these substances for medi-
cal, scientific and industrial purposes. Most of the countries
and territories of Oceania provided the required reports for
narcotics drugs controlled under the 1961 Convention as
amended for 2021. For psychotropic substances controlled
under the 1971 Convention, approximately three quar-
ters of the countries and territories provided the required
reports for the last five years, including most of the required
information. A few countries have not provided any of the
required reports regarding narcotic drugs and psychotropic
substances in the last five years.
954. In 2002, the level of consumption of opioid analge-
sics in Oceania, expressed in S-DDD per million inhabit-
ants, stood at 14,974 S-DDD
pm
. It had doubled by 2021,
reaching 29,167 S-DDD
pm
. The largest amounts in 2021
were consumed in Australia (7,675 S-DDD
pm
) and New
Zealand (6,508 S-DDD
pm
). However, a number of small
territories also reported high levels of S-DDD
pm
(Norfolk
Island, 7,565 S-DDD
pm
; New Caledonia, 3,176 S-DDD
pm
;
and French Polynesia, 1,946 S-DDD
pm
) owing to the fact
that the amounts of opioid analgesics reported is standard-
ized in daily dose per capita and therefore, given the limited
populations, small actual amounts of opioids translate into a
high level of S-DDD
pm
. Wallis and Futuna Islands reported
721 S-DDD
pm
, followed by Palau (463 S-DDD
pm
), Christmas
Island (459 S-DDD
pm
), Samoa (209 S-DDD
pm
) and Fiji
(170 S-DDD
pm
). Other countries in the region reported
smaller or no amounts. The majority of the consumption in
Oceania was of fentanyl (16,893 S-DDD
pm
), followed by mor-
phine (5,850 S-DDD
pm
), oxycodone (5,518 S-DDD
pm
), peth-
idine (225 S-DDD
pm
) and hydromorphone (159 S-DDD
pm
).
955. It remains challenging to determine the levels of con-
sumption of psychotropic substances in Oceania, because
fewer than half of the region’s countries and territories have
provided to the Board consumption data on any psycho-
tropic substance for the past five years.
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INCB REPORT 2023
956.
The Board encourages the countries and territories
of Oceania that have not provided the reports under the
international drug control conventions, in particular on
consumption of psychotropic substances, to do so as soon
as possible and to take the necessary measures to ensure
that their respective competent national authorities have
sufficient resources and training to prepare the reports
in a timely manner. This will significantly improve the
effectiveness and efficiency of the operation of the inter-
national drug control system. The Board encourages
bilateral partners to provide support, including techni-
cal assistance, in this area.
957.
The Board stresses that there is insufficient availabil-
ity of narcotic drugs and psychotropic substances in some
countries of the region and emphasizes the importance
of ensuring sufficient availability of and access to inter-
nationally controlled substances for medical purposes.
958. With regard to precursor chemicals, Member States
voluntarily provide estimates of their annual legitimate
requirements for imports of certain precursor chemicals
frequently used in the illicit manufacture of amphetamine-
type stimulants in the context of Commission on Narcotic
Drugs resolution 49/3. The provision of annual legitimate
requirements is requested for, among other substances,
ephedrine and pseudoephedrine, substances that also have
medicinal uses, as well as, to the extent possible, for prepara-
tions containing those substances that could be easily used
or recovered by readily applicable means.
959. Out of the 16 countries in Oceania, eight (50 per
cent) provided to the Board at least one estimate of annual
legitimate requirements for imports of ephedrine, ephedrine
preparations, pseudoephedrine or pseudoephedrine prepara-
tions. However, three, or 38 per cent, of those eight countries
have not updated their estimates in the past 10 years, which
undermines the potential of annual legitimate requirements
to act as a tool to guide exporting countries with regard to
the legitimate requirements of importing countries, thus pre-
venting oversupply and diversion into illicit channels, as well
as ensuring the availability of those substances for legitimate
purposes. Two countries in Oceania, namely, the Marshall
Islands and Micronesia (Federated States of), have provided
annual legitimate requirements to the Board for the first time
in the last five years.
960. Further information on the availability of interna-
tionally controlled substances can be found in the technical
reports of the Board for 2023 on narcotic drugs,
168
psycho-
tropic substances
169
and the implementation of article 12 of
168
169
the 1988 Convention.
170
In addition, the publication enti-
tled
Guide on Estimating Requirements for Substances under
International Control,
developed by INCB and WHO for use
by competent national authorities, and the document entitled
“Issues that Governments may consider when determining
annual legitimate requirements for imports of ephedrine and
pseudoephedrine” are available on the Board’s website.
4. National legislation, policy and
action
961. In November 2022, nine detector dog teams grad-
uated from the New Zealand Police and New Zealand
Customs Pacific Detector Dog Programme. The teams
were from law enforcement and customs authorities of Fiji,
French Polynesia, New Zealand, Samoa and Tonga.
962. The Australian National Advisory Council on Alcohol
and Other Drugs published its first communiqué in June
2023, outlining discussions that covered, inter alia, options
for addressing addiction medicine workforce shortages, the
potential benefits of developing a national research agenda on
alcohol and other drugs, and implementation of the National
Quality Framework for Drug and Alcohol Treatment Services,
an update of which had been published in April 2023.
963. In July 2023, the police force of the Australian State
of New South Wales announced the creation of a new task
force to coordinate investigations and operations related
to recent shootings that had taken place in public places in
Sydney and that were believed to be related to organized
crime and illicit drug supply. The task force was also to take
a proactive approach to hindering potential future activity,
with a view to restoring a sense of safety in the commu-
nity. Organized crime-related homicides increased in New
South Wales during the 2021/22 reporting period, and the
significant decline in sea and air freight to Australia during
the COVID-19 pandemic was accompanied by increased
competition between organized criminal groups over drug
trafficking networks. The near doubling of the price of
cocaine compared to pre-pandemic prices also provided a
substantial financial incentive for organized criminal groups.
964. From 1 July 2023, medicines containing psilocy-
bin and MDMA could be prescribed by authorized psy-
chiatrists in Australia for the treatment of, respectively,
treatment-resistant depression and post-traumatic stress
disorder. For these specific purposes, the substances will
be listed as Schedule 8 (Controlled Drugs) medicines in the
Poisons Standard. For all other purposes, the substances will
remain in Schedule 9 (Prohibited Substances), which limits
170
E/INCB/2023/2.
E/INCB/2023/3.
E/INCB/2023/4.
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their use to clinical trials. In order to prescribe MDMA or
psilocybin for the aforementioned conditions, psychia-
trists must be registered under the Authorised Prescriber
Scheme and must obtain approval from a human research
ethics committee. The Royal Australian and New Zealand
College of Psychiatrists released guidance for psychiatrists
to help prevent adverse outcomes for patients prescribed
these substances. The advertising of psilocybin and MDMA
to Australian consumers remained illegal. In 2023, the
Australian Therapeutic Goods Administration announced
that it was prioritizing action to stop the unlawful advertising
of these substances, as well as medicinal cannabis, through
measures including education, intelligence-gathering and
use and compliance action.
965. The Australian Capital Territory Drugs of Dependence
(Personal Use) Amendment Act 2022 came into effect on
28 October 2023. Under the amendment, people found with
small quantities of specific drugs may be issued with a simple
drug offence notice, which can be discharged by paying a
fine of 100 Australian dollars or participating in an illicit
drug diversion programme assessment and harm reduc-
tion session, instead of facing a potential prison sentence.
The amendment defines small quantities of amphetamine,
cocaine and methamphetamine as 1.5 g, and of other sub-
stances as follows: 1.5 g of MDMA; 50 g of dried cannabis;
150 g of harvested cannabis; 1 g of heroin; 0.001 g of lysergic
acid or LSD; and 1.5 g of psilocybin.
966. Raising awareness about drugs in schools and tertiary
institutions was highlighted as a priority for policing in Fiji,
with activities held in schools in July 2023. In April 2023,
a proactive narcotics workshop was held by the Narcotics
Bureau in Labasa, Fiji, for police officers.
967. In December 2022, temporary class drug orders
under the New Zealand Misuse of Drugs Act 1975 were
issued for one-year periods for the benzodiazepine deriva-
tive bromazolam and the synthetic cannabinoids ADB-
5Br-INACA, MDMB-5Br-INACA and MDMB-INACA as
Class C1 controlled drugs. These substances are currently
not under international control.
968. Amendments to the Misuse of Drugs Regulations
1977 that came into effect in December 2022 expanded
the New Zealand ePrescription Service so that prescribers
could issue signature-exempt prescriptions for medicines
containing controlled drugs. This was aimed at reducing
the administrative burden for prescribers and pharmacists,
as there was previously a requirement for the prescriber to
provide a signed hard copy of any prescription for a medi-
cine containing a controlled drug. The ultimate goal of the
amendments was to improve access to Class B controlled
drugs for people in palliative care or with chronic conditions
such as attention deficit hyperactivity disorder (ADHD) and
cancer. The amendments would also allow prescriptions for
Class B controlled drugs to cover a period of up to three
months when issued through the system, which was expected
to improve access for patients. Subsequently, a Cabinet deci-
sion was taken in July 2023 to reduce the maximum limit for
opioid prescriptions from three months to one, to apply to
both Class B and Class C opioids, bringing the prescribing
limit for Class C opioids (such as codeine) into line with
that for Class B opioids. The changes were made to reduce
the risk of harm associated with opioid prescribing while
ensuring regular clinical review and continued access to
these medicines. The changes were planned to come into
effect in late 2023. In addition, a number of interim safeguard
measures were implemented to manage risks associated with
opioid prescribing, including regulations setting out who
could prescribe opioid medicines, monitoring of prescribing
practices, clinical guidance, professional sanctions in cases of
inappropriate prescribing and the Pharmac Pharmaceutical
Schedule, which provides criteria limiting the amount of
Class B opioids that may be prescribed and dispensed.
969. In 2022, Palau released its National Security Strategy,
comprising six pillars, one of which was transnational crime.
The Government noted that although illicit drug markets in
the country were fairly limited, they continued to operate
counter to the laws, culture and values of the country. The
Strategy outlined the negative impact of illicit drug abuse
on public health and the national health-care system, and
highlighted the significant negative socioeconomic impacts
of methamphetamine. In February 2023, a memorandum
of understanding was signed between the Bureau of Public
Safety, the Ministry of Justice, the Palau Bureau of Customs
and Border Protection and the Ministry of Finance with
a view to advancing cooperation in law enforcement and
border management in the country.
970. In November 2022, the Samoa Police, Prisons and
Corrections Services met with the Scientific Research
Organization of Samoa to discuss future collaborative work
on drug testing to support police investigations and court
prosecutions.
971. In February 2023, training was held in Tonga for law
enforcement officers on the operation of a drone acquired
through the Illicit Drugs Response Fund.
5.
Cultivation, production,
manufacture and trafficking
972. Seizures of drugs and precursors at the Australian
border increased by 18.1 per cent between 1 July 2022
and 28 February 2023 compared with the period between
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INCB REPORT 2023
1 July 2021 and 28 February 2022, with cocaine being seized
at unprecedented levels. Operation Tin Can, conducted
from 14 November to 9 December 2022, was organized by
WCO, UNODC and the Australian Border Force in coop-
eration with members of the World Shipping Council, with
the participation of enforcement agencies of 58 countries.
The Operation, which focused on tackling organized crime
and insider threats exploiting the container supply chain,
resulted in the global seizure of 98.7 tons of cocaine and
314 kg of cannabis. On the basis of wastewater analysis, it
was estimated that only up to a quarter of the drugs that
reached the border were seized.
973. Methamphetamine is trafficked into Australia from
the Mekong region of South-East Asia and Mexico and other
countries, with around 70 per cent of the methamphetamine
seized in Australia sourced from Myanmar. The amount
of methamphetamine concealed in tea packages, or “tea
packet methamphetamine”, seized in Australia has increased
since 2019. Tea package designs have been used by criminal
groups over the past decade to conceal and market metham-
phetamine illicitly produced in South-East Asia. In 2022, the
Australian Federal Police seized more than two tons of such
methamphetamine, with Thailand, Malaysia, Myanmar, Viet
Nam and Indonesia identified as the top five countries con-
tributing to its importation. The Australian Federal Police
were targeting outlaw motorcycle gangs involved in traffick-
ing in methamphetamine from Afghanistan to Australia.
Since 2021, more than 250 kg of methamphetamine pro-
duced in Afghanistan had been prevented from arriving in
Australia, with the majority intercepted offshore, including
in Pakistan. In 2022, the Australian Border Force seized
26 kg of methamphetamine produced in Afghanistan in 19
separate imports, primarily concealed in packages sent by
international mail.
974. Preliminary data indicated that seizures of meth-
amphetamine by New Zealand Customs increased from
844 kg in 2021 to 1,819 kg in 2022. January 2023 saw a
record seizure of 713 kg of methamphetamine at the New
Zealand border, concealed in a shipment of maple syrup
from Canada. In March 2023, a seizure of 83 kg of meth-
amphetamine was made at Port Napier, New Zealand, des-
tined for the local market; it represented the first major drug
seizure arriving from South Africa via sea freight. For the
first time, in March 2023, New Zealand Customs seized
15.24 kg of crystal methamphetamine trafficked directly
from Afghanistan by mail in three consignments.
975. A large increase was seen in cocaine trafficking to
New Zealand. In January 2023, a joint police, customs and
defence force operation resulted in the seizure of 3,348 kg
of cocaine in the Pacific Ocean north-east of New Zealand,
believed to have been destined for Australia.
976. A record seizure of 174 kg of ketamine, a substance
not under international control, was made in Australia in
July 2023, including 80 kg of ketamine concealed inside
liquid cement shipped from Spain, together with 25 kg of
MDMA. In May 2023, the Australian Border Force seized
84 kg of ketamine concealed inside new commercial vans
imported to the country. In New Zealand, it was reported
that the amount of ketamine seized from January to April
2023 was significantly larger than in the same period in
2022. March 2023 saw the largest monthly amount of
MDMA seized in New Zealand since January 2019, primar-
ily made up of one large seizure of almost 20 kg.
977. In February 2023, the Australian Federal Police
issued a warning about synthetic drugs, in view of the
import of a new synthetic stimulant, dimethylpentylone,
into the country, first detected in Australia in October 2021.
Forty-four consignments of the substance were detected
by the Australian Border Force in 2022. Seizures by the
Australian Federal Police of the substance in parcel post
and air cargo ranged from around 100 g to 10 kg. In New
Zealand in 2022, there was a significant increase in the
detection of the new psychoactive substances dimethyl-
pentylone and bromazolam, which had replaced eutylone
and etizolam on the illicit market. In addition, the follow-
ing new psychoactive substances were identified for the
first time in New Zealand in 2022: deschloroetizolam, flu-
brotizolam, flubromazepam, etonitazepyne, metonitazene,
2-Fluorodeschloroketamine, 25B-NBOH, MDMB-5Br-
INACA, MDMB-INACA, 3,4-methylenedioxy-N-tert-
butylcathinone, N-cyclohexylmethylone, ADB-FUBIATA,
gidazepam and fluorexetamine.
978. The use of Pacific island States to traffic drugs
to Australia and New Zealand continues, as evident in
a number of seizures, such as 247 kg of cocaine seized
from a yacht moored in Townsville, Australia, which had
sailed from Vanuatu, and methamphetamine trafficked to
Australia via Fiji.
979. Seizures of cannabis, cocaine, ketamine and meth-
amphetamine were reported by the police and customs
authorities in Fiji in 2023, both in the country and at the
borders. Cannabis cultivation continued in Fiji, with the law
enforcement authorities reporting the eradication of over
6,000 cannabis plants on the island of Kadavu and in the
Vunikoko Highlands in May and July 2023. In June 2023,
the Nauru Police Force reported the seizure of 15 cannabis
plants in Anibare district.
980. In March 2023, an attempt was made to traffic 52 kg
of methamphetamine from Papua New Guinea to Australia
on a “black flight” that had departed from and returned to
central Queensland. A black flight refers to a light aircraft
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ChAPTER III. ANALySIS Of ThE WORLD SITuATION
131
for which no or false flight plans are logged, that flies at a
very low altitude, or that turns off flight monitoring systems
in order to avoid detection by law enforcement authorities
or aviation monitoring systems.
981. The Samoa Police, Prisons and Corrections Services
expressed deep concern over the growing trend in the use
of electronic devices for the exchange of drugs, particularly
methamphetamine. In 2023, numerous seizures of cannabis
and methamphetamine were reported in the country.
982. In Tonga in April 2023, over 1 kg of methampheta-
mine trafficked inside a shipment from the United States was
intercepted by customs officers with the assistance of Tonga
Police detector dogs. Small quantities of methamphetamine
and cannabis were seized domestically in the country on a
regular basis.
983. Information on the control of precursors and chemi-
cals frequently used in the illicit manufacture of narcotic
drugs and psychotropic substances can be found in the
report of the Board for 2023 on the implementation of arti-
cle 12 of the 1988 Convention.
171
the National Community Police Department of RSIPF, con-
ducted a “copen” awareness-raising programme in schools
in Honiara. The programme comprised interaction between
facilitators and students, and informative presentations
aimed at educating students about the dangers of “copen”,
the identification of risks and protective factors, and how
to respond to peer pressure. A reduction in the use of the
substance was observed after the implementation of the
programme.
986. Wastewater analysis covering about 55 per cent of the
population of Australia between August and December 2022
found that consumption of heroin, oxycodone and cannabis
had decreased, while consumption of methamphetamine,
cocaine, MDMA, tenamfetamine (MDA), fentanyl and keta-
mine had increased. The increase in cocaine consumption
followed a record low recorded in August 2022. Fentanyl
consumption had been increasing since April 2022 and
exceeded oxycodone consumption for the first time since
April 2021. Record lows were seen in oxycodone con-
sumption in December 2022 (outside capital cities) and in
February 2023 (in capital cities).
987. In a sentinel group of adults residing in capital cities
in Australia who had injected drugs at least once monthly
in the previous six months, prevalence of use in the past
six months of heroin (53 per cent), methamphetamine
(81 per cent), non-prescribed morphine (14 per cent) and
non-prescribed fentanyl (5 per cent) had remained stable
in 2022 relative to 2021. Over the same period, the use of
non-prescribed cannabis and/or cannabinoid-related prod-
ucts within the past six months had increased significantly,
from 67 per cent in 2021, the lowest level since monitoring
began, to 72 per cent in 2022. Half of the respondents who
had recently used these products reported daily use, as in
the previous year. A survey of people who used MDMA and
other stimulants on a regular basis found that recent use
of MDMA had decreased significantly, from 95 per cent in
2021 to 88 per cent in 2022, reaching the lowest level since
monitoring commenced in 2003. Recent use of metham-
phetamine had increased significantly in 2022 (31 per cent)
compared with 2021 (26 per cent). Recent use of cocaine had
remained stable in 2022; however, weekly use had increased
to 11 per cent (up from 7 per cent in 2021). Recent use of
cannabis among the sample had declined from 84 per cent
to 79 per cent over the same period.
988. In Australia, the most common type of drug for
which people sought treatment continued to be ampheta-
mines, primarily methamphetamine, followed by cannabis
and heroin. However, the number of treatment episodes
relating to amphetamines continued to decline in the
12-month reporting period 2021/22, after having almost
tripled between the 12-month reporting periods 2012/13
6. Prevention and treatment
984. There continue to be indications that Pacific island
States are experiencing increased levels of drug use and
treatment demand, including as a consequence of drug
trafficking through the region. However, data on the drug
use situation in the region are still not available.
The Board
reiterates its recommendation that Pacific island States
prioritize the collection of data on the extent and patterns
of drug use and the demand for treatment of drug use
disorders. Such data will aid the development of targeted,
evidence-based drug control policies and drug prevention
and treatment services. The Board also urges bilateral
partners and regional and international organizations
to support Pacific island States to this end.
985. In Solomon Islands, the use of a new substance,
“copen”, was becoming a serious concern in schools. The
substance was made up of tobacco and other substances
such as toothpaste and coral lime, and was reported to have
a psychoactive effect, as well as side effects such as vomiting
and headaches. It was reported to negatively affect concen-
tration and lead to dependence. A survey of school students
aged 8 to 20 found that “copen” use was highly prevalent
among teenagers. In response, the Royal Solomon Island
Police Force (RSIPF) and the RSIPF-Australian Federal
Police Policing Partnership Programme, in cooperation with
171
E/INCB/2023/4.
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INCB REPORT 2023
and 2019/20. The number of treatment episodes related to
pharmaceutical opioids fell to 4,700 in the 12-month report-
ing period 2021/22, compared with a peak of 7,700 episodes
in the 12-month reporting period 2013/14. The number of
treatment episodes related to benzodiazepines increased to
3,200 in the 12-month reporting period 2021/22.
989. On the basis of preliminary estimates, there were
1,788 drug-induced deaths in Australia in 2021, accounting
for 1 per cent of all registered deaths in the country that year.
The estimated rate of overdose deaths involving opioids,
which were the most commonly identified type of substance,
was lower in 2021 than in 2020. The rate of overdose deaths
involving amphetamine-type stimulants was lower in 2021
than in 2020, when it had reached a record high.
990. According to the New Zealand Health Survey for
the period July 2021 to July 2022, 14.7 per cent of adults
had used cannabis within the past 12 months, compared
with 15.3 per cent in the period from July 2020 to July 2021.
Weekly use of cannabis was estimated at 4.3 per cent of
adults, similar to the previous year (4.5 per cent). Past-year
cocaine use was estimated at 1.1 per cent of adults, a similar
level to the previous year (1 per cent). Past-year “ecstasy”
use among adults declined from 4.8 per cent to 4.3 per cent,
while use of amphetamine-type stimulants increased from
1 per cent to 1.3 per cent of adults. Past-year non-medical
use of opioids among adults had doubled over the past year
to 1.2 per cent. The annual prevalence of non-medical use
of sedatives and hallucinogens had also increased compared
with the previous year, from 0.9 per cent to 1.2 per cent, and
from 1.9 per cent to 2.5 per cent, respectively.
991. Analysis of wastewater covering about 75 per cent of
the population of New Zealand found a reduction in con-
sumption of methamphetamine and MDMA in the fourth
quarter of 2022 compared with average consumption in the
previous four quarters. Cocaine consumption was found
to have increased compared with average consumption
detected over the previous four quarters. Heroin was not
detected in reportable quantities in 2022, and fentanyl was
only detected at a reportable level in the third quarter in
two districts.
992. Over the past year, the early warning system of New
Zealand, High Alert, issued notifications about a danger-
ous batch of synthetic opioids linked to serious hospitali-
zations, the potent stimulant
alpha-PV
detected in a white
powder misrepresented as MDMA, and the synthetic
cannabinoid MDMB-4en-PINACA detected in a yellow
powder presumed to be N,N-Dimethyltryptamine (DMT).
The service also reissued a notification about serious harm
linked to metonitazene, a highly potent opioid, and fake
oxycodone tablets found to contain metonitazene, possibly
linked to one death and a series of serious hospitalizations. It
appeared that the non-medical use of ketamine was increas-
ing in New Zealand, and in the first half of 2023, an increase
in ketamine analogues was observed in the country. In the
Australian State of Queensland, an official warning was
issued in April 2023 about fake Xanax tablets found to con-
tain protonitazene, a highly potent opioid, and bromazolam,
a non-medical benzodiazepine. Two deaths were linked to
the use of the tablets.
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Chapter IV.
Recommendations to Governments, the United
Nations and other relevant international and
national organizations
993. Following its review of the implementation of the
international drug control conventions, the Board would
like to present to Governments and relevant international
and regional organizations its main conclusions and recom-
mendations, which are set out below.
Internet-facilitated drug markets to further expand as the
related technological components continue to evolve and
larger shares of the global population use social media.
996. Currently, the urgent macro-level challenges to
international drug control are the misuse, diversion from
domestic trade and evolution of designer and pre-precursor
chemicals and new psychoactive substances, including non-
medical synthetic opioids, that are not under international
control. At the micro level, the Internet and, in particular,
social media, in combination with encryption technologies,
have increased the availability of drugs on the illicit market
and made law enforcement interventions more difficult.
997. Some of the key areas of concern related to the
Internet and drug control include the following: easier
connectedness between sellers and potential buyers of
illicit commodities across the globe enabled through broad
Internet access, encryption technologies and innovations
helping hide users’ identities, modified smartphones,
“cryptophones” or “PGP” phones running specialized soft-
ware, cryptomarkets and Deep Web markets, the increased
availability and proliferation of social media platforms, and
the misuse of legitimate e-commerce platforms and online
pharmacies. The international community needs to con-
sider these issues collectively, drawing on the expertise,
across various organizations, of specialists in cybercrime
and money-laundering, as well as in trafficking in drugs
and firearms, counterfeiting and other forms of smuggling.
998. Meeting the challenges and opportunities afforded
by the Internet is currently reliant on voluntary coopera-
tion with social media companies. Internet-facilitated drug
trafficking using conventional social media requires new and
concurrent responses based on public-private partnerships.
133
The role of the Internet, including
social media, and consequences for
drug trafficking and use
994. The international community adopted the Single
Convention on Narcotic Drugs of 1961 and the Convention
on Psychotropic Substances of 1971 prior to the advent of
the Internet, and the United Nations Convention against
Illicit Traffic in Narcotic Drugs and Psychotropic Substances
of 1988 shortly before the major changes in information and
communication technologies became global in reach. The
Internet has proved both to offer opportunities to support
the aims of the conventions and to undermine those aims,
as it enables communication that facilitates trade and the
trafficking in and use of narcotic drugs, psychotropic sub-
stances and precursor chemicals.
995. Criminals have adapted to the new informational
and technological environment. The growth in online
drug trafficking follows the broader trend in Internet use
and Internet-facilitated trade. The role of the Internet in
drug trafficking and in the sourcing of precursor chemi-
cals and equipment for illicit drug manufacture has evolved,
but has not yet dramatically changed drug supply chains.
While the share of illicit transactions that occurs online is
still marginal, it constitutes a larger share of the global drug
market every year and there is considerable potential for
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INCB REPORT 2023
This requires a longer-term effort to build international con-
sensus and improve the capacity of Governments to engage
with the private sector. Public-private partnerships should
include key industries, academia and non-governmental
organizations working with people who use drugs in the
development of effective responses.
Recommendation 1:
The Internet offers potential for both
improving international drug control and preventing
non-medical drug use. At the same time, it provides new
opportunities for trafficking in and the non-medical use of
controlled drugs. To optimize the opportunities provided
by the Internet, the international community should con-
sider using social media to conduct drug abuse prevention
campaigns and to promote awareness-raising messages
on drug-related risks. At the same time, to mitigate the
related threats, the international community needs to
consider this issue collectively, drawing on the expertise,
across various organizations, of specialists in cybercrime
and money-laundering, as well as in trafficking in drugs
and firearms, counterfeiting and other forms of smuggling.
999. For additional recommendations and more details on
proposed action, please refer to the section entitled “The role
of the Internet, including social media, and consequences
for drug trafficking and use”, contained in chapter I of the
present report.
Recommendation 2:
The Board reiterates that universal
ratification of the international drug control conventions
is important for strengthening the international licit drug
control framework and for preventing traffickers from
targeting non-parties owing to actual or perceived weak-
nesses in the scope of control of scheduled substances.
Accordingly, the Board urges those States not yet having
become parties to one or more of these instruments to
do so without delay and to take steps to ensure their full
implementation within their national legal orders.
Use of cannabis for non-medical
purposes
1001. The Board continues to reiterate its concern regard-
ing the legalization of the use of cannabis for non-medical
and non-scientific purposes in several jurisdictions, with
other jurisdictions considering similar action. The Board
reiterates that the 1961 Convention as amended, the 1971
Convention and the 1988 Convention limit the use of all
controlled substances to medical and scientific purposes.
1002. The developments in a few countries that have legal-
ized or permitted the use of cannabis for non-medical pur-
poses or that have tolerated its legalization at the subnational
level are undermining the universal adherence to the three
international drug control conventions and the commitment
to their implementation, which was reaffirmed by Member
States at the special session of the General Assembly on
the world drug problem held in 2016 and in the 2019
Ministerial Declaration on Strengthening Our Actions at the
National, Regional and International Levels to Accelerate
the Implementation of Our Joint Commitments to Address
and Counter the World Drug Problem.
Recommendation 3:
The Board wishes to recall the the-
matic chapter contained in its annual report for 2022, in
which it addressed the trend of legalizing the use of can-
nabis for non-medical and non-scientific purposes, and
to remind all parties to the 1961 Convention as amended
that, under article 4, paragraph (c), thereof, and subject to
the provisions of that Convention, the production, manu-
facture, export, import, distribution of, trade in, use and
possession of drugs are limited exclusively to medical
and scientific purposes. The apparent tension between
these provisions and the trend towards legalization must
be addressed by the signatories to the three drug control
conventions.
Universal adherence to the
international drug control
conventions
1000. The three international drug control conventions
represent the international consensus on requirements for
the control of licit trade in narcotic drugs, psychotropic
substances and precursor chemicals that can be diverted,
and on the measures needed to facilitate access to and the
availability of controlled substances for legitimate medi-
cal and scientific purposes. The conventions provide a
common normative framework for effective international
drug control, in particular in their capacity as the legal basis
for international cooperation, extradition and mutual legal
assistance. As such, the Board continues to engage with
States having yet to become party to one or more of the
three conventions with the aim of supporting them in this
pursuit and to encourage the comprehensive incorporation
of the conventions into national law. By becoming parties
to the conventions, States demonstrate their common and
shared responsibility for meeting those minimum require-
ments with a view to achieving the aim of the conventions,
which is the health and welfare of humankind.
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ChAPTER IV. RECOmmENDATIONS TO GOVERNmENTS, uNITED NATIONS, INTERNATIONAL AND NATIONAL ORGANIZATIONS
135
International drug control
conventions and human rights
1003. The fundamental goal of the international drug
control conventions, to safeguard the health and welfare
of humanity, includes the full enjoyment of human rights.
States’ actions that violate human rights in the name of
drug control policy are inconsistent with the international
drug control conventions. Extrajudicial responses to sus-
pected drug-related activities cannot be justified under
international law, including under the international drug
control conventions.
Recommendation 4:
The Board reiterates its appeal to
Governments to take all measures necessary to prevent
the extrajudicial targeting of persons suspected of involve-
ment in drug-related offences. The Board also reiterates in
the strongest possible terms that extrajudicial responses
to drug-related criminality are in violation of the drug
control conventions and fundamental human rights,
which require that drug-related crimes be addressed
through formal processes adhering to due process of law.
Governments are called upon to investigate and prosecute
all instances of extrajudicial action purportedly taken in
the name of drug control.
1004. The Board notes with concern public reports of the
continued use of the death penalty for drug-related offences
in a number of countries.
Recommendation 5:
While recalling that, according to the
international drug control conventions, the determina-
tion of penalties applicable to drug-related behaviours
remains the exclusive prerogative of States parties, the
Board encourages all States that retain the death penalty
for drug-related offences to consider abolishing the death
penalty for drug-related offences and to commute death
sentences that have already been handed down, in view
of the relevant international conventions and protocols
and relevant resolutions of the General Assembly, the
Economic and Social Council and other United Nations
bodies on the application of the death penalty for the cat-
egory of drug-related offences.
1005. Owing to the limited availability of proper treat-
ment services, an increased number of patients have been
directed to compulsory treatment facilities where deterio-
rating conditions have been observed in some countries.
Additionally, despite a call by a number of United Nations
agencies in 2012, many countries throughout the world still
retain compulsory systems for the treatment of persons with
drug use disorders.
Recommendation 6:
The Board calls upon those Member
States that have not already done so to shift efforts from
compulsory and involuntary treatment services for people
who use drugs towards alternatives to imprisonment and
punishment in drug treatment and rehabilitation.
Drug treatment and rehabilitation
1006. Over the past decade, the international commu-
nity has highlighted the need for the voluntary treatment
of people who use drugs, adopting health- and people-
centred approaches that incorporate human rights concerns.
However, many countries still lack mechanisms for gather-
ing information on the scope and nature of drug use and
treatment demand. That hinders the ability to determine
the scope and consequences of drug use. It also hinders
Governments and the international community as they seek
to respond effectively through evidence-based drug use pre-
vention and treatment programmes.
Recommendation 7:
The Board encourages countries to
prioritize the collection of data on drug use trends and
treatment demand in order to inform the development
of evidence-based approaches in the area of prevention
and treatment, and encourages bilateral partners and
regional and international organizations to provide sup-
port to that end.
Recommendation 8:
The Board encourages Governments
to strengthen capacity-building in drug use management,
data collection and data-sharing, public policies and treat-
ment and rehabilitation services, and to continue collabo-
rating with the international community in that respect.
Recommendation 9:
The Board urges Governments to
ensure access to voluntary, evidence-based treatment
services in line with the UNODC/WHO International
Standards for the Treatment of Drug Use Disorders. In
doing so, Governments should address systemic dispari-
ties and ensure inclusivity in treatment services, with spe-
cial attention given to vulnerable groups. The Board also
encourages Member States to continue to focus on initia-
tives to combat stigma and discrimination in relation to
people who use drugs.
Recommendation 10:
The Board urges Member States
to implement continuous review mechanisms directed
at treatment services in their territories with the aim of
ensuring that they are in line with the UNODC/WHO
International Standards for the Treatment of Drug Use
Disorders.
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INCB REPORT 2023
Availability of internationally
controlled substances for medical
and scientific purposes
1007. Through the international drug control conven-
tions, the international community made a commitment
to ensure – and not unduly restrict – the availability of drugs
considered indispensable for medical and scientific pur-
poses. Despite that commitment, there remains a signifi-
cant imbalance in the availability of controlled substances
globally, an imbalance which not only goes against the aim
of the international drug control conventions to promote
the health and welfare of humankind but also contradicts
numerous human rights instruments that contain the right
to health or medical care, which also encompasses palliative
care. The data available confirm the persistent disparities
between regions in the consumption of opioid analgesics
for the treatment of pain.
Recommendation 11:
The Board reiterates that there is a
need to improve the availability of and access to opioid
analgesics and to increase their prescription and use in
all countries and territories, and reiterates its calls for tar-
geted public policies supported by Governments, health
systems and health professionals, civil society, patient
organizations and communities, the pharmaceutical
industry and the international community.
1008. In a few regions of the world, countries have main-
tained high levels of availability of some controlled sub-
stances, in particular opioid analgesics, although the levels
of consumption of those substances have been observed to
have decreased in recent years.
Recommendation 12:
The Board highlights the impor-
tance of ensuring that narcotic drugs and psychotropic
substances are available for legitimate purposes while
putting in place adequate policies and practices to avoid
overprescription and prevent misuse. The Board reminds
Governments of the need to foster responsible prescrip-
tion practices and controls on distribution to avoid diver-
sion into illicit channels and overconsumption resulting
in dependence and associated harms.
adequate availability of controlled substances for medical
and scientific purposes but also to uncover diversions of
controlled substances for illicit purposes.
Recommendation 13:
The Board encourages those coun-
tries and territories that have not provided the reports as
required under the international drug control conventions
to do so as soon as possible and to take the necessary meas-
ures to ensure that their respective competent national
authorities have sufficient resources to prepare the reports
in a timely manner. In this regard, INCB offers the pos-
sibility of training, including through its INCB Learning
programme, to support capacity-building in the area of
reporting.
1010. The Board makes platforms such as I2ES, PEN
Online and PEN Online Light available to Governments
to enable secure trade in narcotic drugs, psychotropic sub-
stances and internationally controlled and non-controlled
precursor chemicals. The Board also makes available the
PICS and IONICS platforms to allow drug control authori-
ties to exchange information in real time to report incidents
of trafficking in precursor chemicals and synthetic drugs.
Recommendation 14:
The Board urges Governments to
actively use the PEN Online, PEN Online Light, PICS
and IONICS platforms and to participate in GRIDS
Programme activities in order to prevent the diversion
of and investigate trafficking incidents involving inter-
nationally controlled substances, scheduled precursors,
non-scheduled chemicals, illicit drug manufacturing
equipment, new psychoactive substances, non-medical
synthetic opioids and related dangerous substances.
INCB Learning
1011. The importance of capacity-building for ensuring
the adequate availability of internationally controlled sub-
stances for medical and scientific purposes while preventing
diversion and misuse was recognized by the international
community in the outcome document of the thirtieth spe-
cial session of the General Assembly, entitled “Our joint
commitment to effectively addressing and countering the
world drug problem”. That commitment was reiterated by
Member States through the adoption, in March 2019, of
Commission on Narcotic Drugs resolution 62/5, entitled
“Enhancing the capacity of Member States to adequately
estimate and assess the need for internationally controlled
substances for medical and scientific purposes”. In that reso-
lution, the Commission encouraged the INCB secretariat
to continue implementing capacity-building and train-
ing activities for competent national authorities through
the INCB Learning global programme. Accurate national
Data collection and analysis
practices of the Board
1009. The regular submission of comprehensive and reli-
able statistical data from Governments to the Board is vital
for the overall functioning of the international drug control
system and the analysis of global trends. Good-quality data
provide information that is necessary not only to ensure the
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ChAPTER IV. RECOmmENDATIONS TO GOVERNmENTS, uNITED NATIONS, INTERNATIONAL AND NATIONAL ORGANIZATIONS
137
reports are essential for ensuring the availability of con-
trolled substances for medical and scientific purposes. The
impact of INCB Learning training, as evidenced by avail-
able data, has resulted in improvements in the quality and
timeliness of the data submitted to the Board.
1012. INCB Learning has developed five e-modules
to support Governments in key areas of treaty compli-
ance. Three e-modules focus on the following systems:
(a)
estimates of annual legitimate medical and scientific
requirements for narcotic drugs;
(b)
assessments of annual
legitimate medical and scientific requirements for psycho-
tropic substances; and
(c)
estimates of annual legitimate
requirements for imports of precursors of amphetamine-
type stimulants. A further e-module focuses on the inter-
national drug control framework and the role of INCB, and
the fifth e-module, which was developed and launched in
2022, supports Governments in their efforts to ensure the
adequate availability of narcotic drugs and psychotropic
substances. All e-modules offer interactive, self-paced
training.
Recommendation 15:
The Board invites Governments
to consider actively supporting INCB Learning through
participation in its activities and to consider providing
the resources required to ensure the continuation of these
activities.
Recommendation 16:
The Board encourages Governments
to register officials of their competent national authorities
for e-modules and to provide feedback and suggestions
for areas in which the development of further training is
needed.
The outcome of that review is a document entitled “Lessons
from countries and humanitarian aid organizations in facil-
itating the timely supply of controlled substances during
emergency situations”, which identifies important actions
that Governments can take to improve their emergency
preparedness and sets out procedures that they can follow
during emergency situations.
Recommendation 17:
The Board strongly encourages
Governments to review existing national legislation on
controlled substances and make amendments and/or
adopt new provisions that allow for greater flexibility in
the import and export of such substances during emer-
gency situations. This includes permitting their export and
import without the corresponding import authorizations
and/or estimates and setting out clear specifications of the
conditions under which such flexibility can be exercised.
Free trade zones and trafficking in
drugs and precursors
1014. Free trade zones, also known as free zones or free
ports, have played a pivotal role in promoting international
trade and economic development across the globe. These
designated areas, often exempt from many of the usual
customs, import and export regulations, facilitate the
movement of goods, foster foreign investment and create
employment opportunities. However, they are susceptible
to misuse for illicit activities. The limited supervision, if any,
exercised by customs authorities over shipments of goods
from abroad into free trade zones, or from such zones to for-
eign countries, provides for the faster movement of goods,
thereby lowering transaction costs. However, it also allows
contraband to move undetected through those zones. In
general, softened customs controls in free trade zones have
made such zones increasingly vulnerable to a wide range of
abuses by criminal actors.
Recommendation 18:
The Board reiterates that States
parties to the international drug control conventions are
required to apply drug control measures in free ports and
free zones that are no less stringent than those applied
in other parts of their territories, and have the option
of applying more stringent measures as outlined in the
conventions.
172
Ensuring that drug control measures are
upheld in free ports and free zones is imperative to pre-
venting trafficking in internationally controlled narcotic
drugs, psychotropic substances and precursor chemicals.
Ensuring access to and availability of
controlled substances for
international humanitarian
emergencies
1013. The increasing number of emergency situations
caused by climate change and armed conflict have led to
greater demand not only for international humanitarian
assistance but also for controlled substances for the provi-
sion of essential care in humanitarian settings. Since the
beginning of 2020, when an increasing number of coun-
tries were declaring national emergencies relating to the
COVID-19 pandemic, the effectiveness of simplified con-
trol measures during emergency situations has been tested.
INCB organized and conducted a review of and discussion
on the lessons learned in the implementation of those meas-
ures among competent authorities, international humani-
tarian organizations and related United Nations agencies.
Article 31, paragraph 2, of the 1961 Convention, article 12, para-
graph 3 (a) of the 1971 Convention, and article 18 of the 1988 Convention.
172
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INCB REPORT 2023
Drug-related crime and the
environment
1015. The impact of illicit drug-related activities on
the environment takes different forms around the globe,
including deforestation, contamination of rivers and soil,
and animal and human poisoning. Indirectly, the illicit pro-
duction, manufacture and trafficking of drugs can also be
linked to other environmentally damaging activities, such
as illicit mining. The impact of those activities often affects
local communities most adversely, as it may destroy live-
lihoods and introduce violence and drug use to popula-
tions in remote areas. While the connection between illicit
drug-related activities and environmental consequences still
requires further research, there is growing evidence showing
that there are significant linkages at play.
Recommendation 19:
The Board calls on Governments,
with the support of the international community, to
take urgent action to address such threats, prioritizing
the safety and well-being of local, native and vulnerable
populations, as well as the protection of the environment.
Furthermore, the Board urges Governments to collaborate
with the international community and with the United
Nations system in improving the available research and
data on the dynamics of illicit drugs and the environment
and the related impacts across all regions of the globe.
targeting platforms; the eLearning Individual Training
Environment (ELITE), recommended in Commission on
Narcotic Drugs resolution 66/2; the Scanning of Novel
Opioids on Online Platforms (SNOOP) tool, for detec-
tion and dismantling of online vendor marketplaces; and
INCB GRIDS Programme training.
Recommendation 21:
The Board encourages all
Governments to have their relevant law enforcement and
regulatory agencies join the agencies of other Governments
that already exchange real-time information through the
IONICS bulk communication feature with regard to new
psychoactive substances, non-medical synthetic opioids
and related drugs that are seized or stopped or are other-
wise suspicious shipments and to facilitate backtracking
investigations involving such substances.
Recommendation 22:
The Board stands ready to assist
Governments to engage its relevant private sector partners
with the goal of voluntarily identifying, preventing and
eliminating the exploitation of legitimate business activi-
ties by traffickers of dangerous synthetic opioids not under
international control and which have no known legitimate
use. Governments are encouraged to make use of a series
of practical guidelines prepared under the INCB GRIDS
Programme to promote voluntary cooperation with the
express courier industry, the freight forwarding industry,
the e-commerce industry and Internet-related services.
Recommendation 23:
The Board invites all Governments
and, through them, industry partners to make use of
the Board’s list of fentanyl-related substances and non-
fentanyl opioids with no known medical, industrial or
other legitimate use, and to voluntarily refrain from any
manufacture, marketing, export, import or distribution
of those substances beyond limited research and analyti-
cal purposes.
Proliferation of highly potent
synthetic non-fentanyl opioids
1016. In addition to the substantial proportion of over-
dose deaths resulting from illicit fentanyl manufacture,
newly emerging highly potent synthetic non-fentanyl opi-
oids are being encountered in drug markets around the
world. Similar to fentanyl and its analogues, the potency of
many of these non-fentanyl opioids, such as analogues of
the nitazene group, makes possible the trafficking of smaller
end-use quantities through express logistics and postal ser-
vices worldwide. Online platforms and services, including
e-commerce, social media and search and financial ser-
vices, are exploited by vendors marketing these dangerous
opioids, which have no known legitimate uses. To assist
Governments in addressing this threat, INCB maintains a
list of fentanyl-related substances and non-fentanyl opioids
with no known medical, industrial or other legitimate uses.
Recommendation 20:
The Board encourages the law and
regulatory enforcement focal points of Governments and
international organizations to take advantage of the suite
of INCB proprietary counter-trafficking tools, including
IONICS, for the secure real-time exchange of informa-
tion; the GRIDS Intelligence HD strategic and operational
Narcotic drugs
1017. The Board, having reviewed the latest informa-
tion and data on the supply of opiate raw materials and
the demand for opiates for medical and scientific purposes,
points out that although data from producing and manufac-
turing countries indicate that the supply of both morphine-
rich and thebaine-rich opiate raw material is calculated to
be sufficient to cover the demand for medical and scientific
purposes as expressed by countries, there are significant
disparities between countries in the availability of narcotic
drugs because many countries do not accurately estimate
their medical needs for opioid analgesics or have only lim-
ited access to them.
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ChAPTER IV. RECOmmENDATIONS TO GOVERNmENTS, uNITED NATIONS, INTERNATIONAL AND NATIONAL ORGANIZATIONS
139
1018. The Board also reminds those countries that culti-
vate opium poppy rich in noscapine to provide information
in a consistent and regular manner about the cultivation
of noscapine-rich opium poppy and its intended use, and
to report to the Board any extraction and use of the inter-
nationally controlled alkaloids, in spite of the fact that
noscapine itself is not an internationally controlled sub-
stance, given that significant amounts of internationally
controlled alkaloids can be extracted from opium poppy
rich in noscapine.
Recommendation 24:
The Board urges major cultivating
countries to ensure, in collaboration with the Board, that
there are no shortages on the global markets of the opiate
raw materials rich in thebaine, codeine and oripavine.
Recommendation 25:
Given that significant amounts of
internationally controlled alkaloids, in particular mor-
phine, can be extracted from opium poppy rich in noscap-
ine, the Board reminds countries to provide information
in a consistent and regular manner about the cultivation
of noscapine-rich opium poppy and to report to the Board
on any such extraction and use of the morphine alkaloid
from this variety.
the increased risk of trafficking in precursor chemicals in
such countries or territories. These areas are particularly
vulnerable to exploitation by traffickers seeking to divert
precursor chemicals from licit channels. Countries wishing
to export precursor chemicals to areas facing conflict or
with an ambiguous political status face practical challenges
in ensuring that precursor chemicals in legitimate trade are
not diverted.
Recommendation 27:
The Board commends all efforts that
contribute to ensuring the availability of controlled pre-
cursors for legitimate purposes in all regions of the world,
irrespective of a territory’s status, while managing the risk
of diversion. The Board further invites all Governments
to work with the Board to devise appropriate ways and
means of monitoring trade pursuant to article 12 of the
1988 Convention and handling pre-export notifications,
with a view to enabling the trade in chemicals to and from
high-risk areas in a regulated manner.
1021. Further information and analysis of trends relat-
ing to precursor chemicals are contained in the Board’s
report on the implementation of article 12 of the 1988
Convention.
173
Psychotropic substances
1019. The 1971 Convention does not require Governments
to provide directly to the Board information on diversions
or seizures of psychotropic substances from licit chan-
nels, although a number of Governments do provide such
information to the Board on a voluntary basis. The Board is
grateful to countries that provide voluntary reports or other
information regarding seizures or other interdiction efforts
with regard to the trafficking in or diversion of psychotropic
substances.
Recommendation 26:
The Board calls upon Governments
to furnish directly to the Board any information on diver-
sions or attempted diversions of psychotropic substances
and to keep the Board appraised of developments in the
trafficking of psychotropic substances.
Ketamine
1022. Many countries have informed the Board that they
have reported ketamine seizures or trafficking in ketamine
in their territory. This included both trafficking in pharma-
ceutical preparations and illicitly manufactured ketamine.
Additionally, information about ketamine precursors is
scarce and not systematically reported by countries, given
that these chemicals are not under international control.
Nevertheless, some countries submit such information to
the Board. Reported seizures of ketamine precursors have
predominantly involved two chemicals. Both substances are
intermediates in the synthesis of ketamine and can readily
be converted into the substance.
Recommendation 28:
The Board commends Governments
that voluntarily report seizures of ketamine precursors,
their sources and related contextual information. Similarly,
the Board commends Governments that use forensic pro-
filing analysis to determine whether seized ketamine has
been illicitly manufactured and from which chemicals.
These efforts help to provide the evidence to prevent illicit
ketamine manufacture while protecting legitimate supply
chains, thus ensuring the availability of ketamine for legiti-
mate purposes. The Board encourages all Governments
to report seizures of ketamine precursors to the Board.
173
Precursor chemicals
1020. While no country is immune to attempts by
traffickers to obtain chemicals for illicit purposes, territories
whose status is unclear or contested or, at any given time,
is not effectively within the scope of control of an inter-
nationally recognized entity’s competent national authori-
ties are at increased risk of being targeted by traffickers.
INCB has on several occasions expressed its concern about
E/INCB/2023/4.
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INCB REPORT 2023
1023. The Board takes note of the information voluntarily
provided by countries regarding the status of control of keta-
mine and the requirements of those countries for import or
export authorizations for trade in the substance. However,
many countries neither control ketamine nor require an
import or export authorization in order to trade in the sub-
stance, which may hinder trade with countries that do.
Recommendation 29:
The Board encourages importing
Governments that do not control ketamine and that do not
require import authorizations for this substance to issue
a letter of no objection or other proof of the legitimacy
of the import in cases where ketamine is imported from
countries where it is controlled.
(Signed)
Jallal Toufiq, President
(Signed)
Mark Colhoun, Secretary
(Signed)
Cornelis P. de Joncheere, Rapporteur
Vienna, 17 November 2023
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Annex I
Regional and subregional groupings used
in  the  report of the International Narcotics
Control Board for 2023
The regional and subregional groupings used in the report of INCB for 2023, together with the States in each of those
groupings, are listed below.
Africa
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cabo Verde
Central African Republic
Chad
Comoros
Congo
Côte d’Ivoire
Democratic Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Eswatini
Ethiopia
Gabon
Gambia
Ghana
Guinea
Guinea-Bissau
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
South Sudan
Sudan
Togo
Tunisia
Uganda
United Republic of Tanzania
Zambia
Zimbabwe
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INCB REPORT 2023
Central America and the Caribbean
Antigua and Barbuda
Bahamas
Barbados
Belize
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Nicaragua
Panama
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
North America
Canada
Mexico
United States of America
South America
Argentina
Bolivia (Plurinational State of)
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela (Bolivarian Republic of)
East and South-East Asia
Brunei Darussalam
Cambodia
China
Democratic People’s Republic of Korea
Indonesia
Japan
Lao People’s Democratic Republic
Malaysia
Mongolia
Myanmar
Philippines
Republic of Korea
Singapore
Thailand
Timor-Leste
Viet Nam
South Asia
Bangladesh
Bhutan
India
Maldives
Nepal
Sri Lanka
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ANNEXES
143
West Asia
Afghanistan
Armenia
Azerbaijan
Bahrain
Georgia
Iran (Islamic Republic of)
Iraq
Israel
Jordan
Kazakhstan
Kuwait
Kyrgyzstan
Lebanon
Oman
Pakistan
Qatar
Saudi Arabia
State of Palestine
Syrian Arab Republic
Tajikistan
Türkiye
Turkmenistan
United Arab Emirates
Uzbekistan
Yemen
Europe
Eastern Europe
Belarus
Republic of Moldova
Russian Federation
Ukraine
South-Eastern Europe
Albania
Bosnia and Herzegovina
Bulgaria
Croatia
Montenegro
North Macedonia
Romania
Serbia
Western and Central Europe
Andorra
Austria
Belgium
Cyprus
Czechia
Denmark
Estonia
Finland
France
Germany
Greece
Holy See
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Monaco
Netherlands (Kingdom of the)
Norway
Poland
Portugal
San Marino
Slovakia
Slovenia
Spain
Sweden
Switzerland
United Kingdom of Great Britain and Northern Ireland
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INCB REPORT 2023
Oceania
Australia
Cook Islands
Fiji
Kiribati
Marshall Islands
Micronesia (Federated States of)
Nauru
New Zealand
Niue
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
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Annex II
Current membership of the International
Narcotics Control Board
César Tomás Arce Rivas
Born in 1954. National of Paraguay. Retired Director
General, Office for National and International Cooperation
and Institutional Strengthening of the National Anti-Drug
Secretariat (2012–2020); Professor of Organic Chemistry,
Faculty of Exact and Natural Sciences, National University
of Asunción (since 1993).
Doctorate in Forensic Chemistry, Center for Forensic
Medicine, Medical University of Vienna (1988–1990);
Bachelor of Science in Chemistry, Faculty of Exact and Natural
Sciences, National University of Asunción (1971–1975).
Previously held positions as Deputy Executive Secretary,
National Anti-Drug Secretariat (2008–2012); Laboratory
Director, National Anti-Drug Secretariat (1987–2007);
Professor of Organic Chemistry I and II, Catholic University,
Ciudad del Este, Paraguay (1996–2008); intern, laboratories
of the Federal Police of Germany (1990).
Author and co-author of and contributor to numerous pub-
lications, including “Drug policy, strategy and action plan
on drugs of Paraguay” (2016) and “Study of the interrela-
tion of cannabinoids in marijuana and determination of the
storage and harvest time of a marijuana sample, by means
of the cannabinoid relation”.
Member of the delegation of Paraguay to the sixtieth session
of the Commission on Narcotic Drugs (2017); meeting of
drug control and drug administration organizations for the
implementation of prevention and treatment courses and the
strengthening of health systems, Inter-American Drug Abuse
Control Commission of the Organization of American States,
held in Cancún, Mexico (2017); 12th Specialized Meeting of
Drug Enforcement Authorities, Southern Common Market
(MERCOSUR), held in Buenos Aires (2017); preparatory
meeting for the special session of the General Assembly on
the world drug problem, held in Vienna (2016); special ses-
sion of the General Assembly on the world drug problem,
held in New York (2016); biregional high-level meetings
of the European Union and the Community of Latin and
Caribbean States on the problem of drugs, held in Buenos
Aires (2017), The Hague (2016), Montevideo (2015), Athens
(2014) and Brussels (2012); South American Council on the
World Drug Problem, Union of South American Nations,
Asunción (2012) (President pro tempore); Specialized
Meetings of Drug Enforcement Authorities, MERCOSUR,
Asunción (2015 and 2009) (President pro tempore);
Twenty-fourth Meeting of Heads of National Drug Law
Enforcement Agencies, Latin America and the Caribbean,
held in Asunción (2014) (Chair); international meeting of
executives for the control of precursors and essential chemi-
cal substances, held in Santiago (1998); tenth, fifteenth, six-
teenth and seventeenth international seminars of forensic
chemistry, Drug Enforcement Administration, Washington,
D.C. (1987–1995); Meeting of Auditors and Evaluators of the
Control of Narcotics and Psychotropic Substances in Public
Health, Santiago (1992).
Member of INCB (since 2020). Member of the Standing
Committee on Estimates (2020–2021). Second Vice-
President and Chair of the Standing Committee on
Estimates (2022). First Vice-President (2023).
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INCB REPORT 2023
Sevil Atasoy
Born in 1949. National of Türkiye. Professor of Biochemistry
and Forensic Science, Vice-Rector and Director, Institute
of Addiction and Forensic Science; Head, Department of
Forensic Science; Director, Center for Violence and Crime
Prevention, Uskudar University, Istanbul. Director, Institute
of Forensic Science, Istanbul University (1988–2010).
Director, Department of Narcotics and Toxicology, Ministry
of Justice of Türkiye (1980–1993). Expert witness in civil and
criminal courts (since 1980).
Bachelor of Science in Chemistry (1972), Master of Science
in Biochemistry (1976), Doctor of Philosophy (PhD) in
Biochemistry (1979), Istanbul University.
Lecturer in biochemistry, criminalistics and crime scene
investigation (since 1982); supervisor of more than 50
master’s and doctoral theses in the area of biochemistry
and forensic science. Author of over 130 scientific papers,
including papers on drug testing, drug chemistry, drug
markets, drug-related and drug-induced crime, drug abuse
prevention, clinical and forensic toxicology, crime scene
investigation and DNA analysis.
Hubert H. Humphrey Fellow, United States of America
Information Agency (1995–1996); Guest Scientist at the
School of Public Health, Department of Forensic Science,
University of California, Berkeley, and the Drug Abuse
Research Center, University of California, Los Angeles;
Department of Genetics, Stanford University; Department
of Human Genetics, Emory University; California
Criminalistics Institute; Federal Bureau of Investigation,
Virginia; Crime Laboratories, Los Angeles Sheriff ’s
Department, United States; Federal Criminal Police Office
(BKA), Wiesbaden; Ludwig-Maximilian University, Munich
Institute for Physical Biochemistry and Institute of Legal
Medicine; Center of Human Genetics, Bremen University;
Institute of Legal Medicine, Muenster University, Germany;
United Nations Drug Laboratory, Vienna; Central Bureau of
Investigation, New Delhi.
Member, special commission on preventing drug abuse,
Office of the Prime Minister (since 2014). Founding Editor,
Turkish Journal of Legal Medicine
(1982–1993). Member
of the scientific board of the
International Criminal Justice
Review.
Founding President, Turkish Society of Forensic
Sciences; Honorary Member of the Mediterranean Academy
of Forensic Sciences. Member of the International Society
of Forensic Toxicology; the Indo-Pacific Association of Law,
Medicine and Science; the International Association of
Forensic Toxicologists; the American Academy of Forensic
Sciences; the American Society of Crime Laboratory
Directors; and the American Society of Criminology.
Member of INCB (2005–2010 and since 2017). Member
(2006, 2018 and 2023) and Chair (2017 and 2020) of the
Committee on Finance and Administration. Second Vice-
President and Chair (2006 and 2021) and member (2007,
2020 and 2022–2023) of the Standing Committee on
Estimates. Rapporteur (2007, 2019 and 2022). First Vice-
President of the Board (2008). President of the Board (2009).
Cornelis de Joncheere
Born in 1954. National of the Kingdom of the Netherlands.
Currently Chair of the Netherlands Antibiotics Development
Platform and a consultant to WHO on pharmaceutical
policies.
Doctor of Pharmacy (PharmD) and Master of Science (MSc)
in Pharmacy, University of Groningen and University of
Amsterdam, Netherlands (Kingdom of the) (1975–1981);
Master’s in Business Administration, University of San
Diego, United States/San José, Costa Rica; Bachelor of Science
(BSc). Pharmacy, cum laude (honour student), University
of Groningen, Netherlands (Kingdom of the) (1972–1975).
Previously held positions as Director, Department of
Essential Medicines and Health Products at WHO, Geneva
(2012–2016), which included work on access to controlled
medicines, and the WHO Expert Committee on Drug
Dependence; WHO Representative, Kyiv (2011–2012);
WHO Regional Adviser for Pharmaceuticals and Health
Technologies, WHO Regional Office for Europe, Copenhagen
(1996–2010); National Essential Drugs Programme
Coordinator, Pan American Health Organization (PAHO)/
WHO, Brazil (1994–1996); Pharmacist, Essential Drugs
Projects Coordinator, PAHO/WHO, Costa Rica (1988–1993);
Pharmaceutical expert, PAHO/WHO, Panama (1986–
1988); pharmaceutical supply expert in Yemen, Ministry of
Foreign Affairs, Directorate for International Cooperation,
Netherlands (Kingdom of the) (1982–1985); hospital and
community pharmacy in Amsterdam, Netherlands (Kingdom
of the) (1981–1982).
President of the WHO Europe Staff Association (2006–
2010); Member of the WHO Guidelines Review Committee
(2007–2011); member of the Royal Dutch Pharmaceutical
Society; author and co-author of numerous publications in
the fields of pharmaceutical and health sciences.
Member of INCB (since 2017). Rapporteur (2017 and
2023). Member of the Standing Committee on Estimates
(2017–2018 and 2021–2022). Member (2017–2018 and
2021) and Chair (2022) of the Committee on Finance and
Administration. President of the Board (2019–2020).
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David T. Johnson
Born in 1954. National of the United States. President,
SwanJohnson LLC; adjunct faculty member, Arizona State
University; retired diplomat. Bachelor’s degree in economics
from Emory University; graduate of the National Defence
College of Canada.
United States Foreign Service officer (1977–2011). Assistant
Secretary for the Bureau of International Narcotics and Law
Enforcement Affairs, United States Department of State
(2007–2011). Deputy Chief of Mission (2005–2007) and
Chargé d’affaires, a.i. (2003–2005), United States Embassy,
London. Afghan Coordinator for the United States (2002–
2003). United States Ambassador to the Organization for
Security and Cooperation in Europe (1998–2001). Deputy
Press Secretary at the White House and Spokesman for the
National Security Council (1995–1997). Deputy Spokesman
at the State Department (1995) and Director of the State
Department Press Office (1993–1995). United States Consul
General, Vancouver (1990–1993). Assistant National Trust
Examiner, Office of the Comptroller of the Currency, United
States Treasury (1976–1977).
Member of INCB (since 2012). Member (2012–2017 and
2022–2023) and Chair (2014 and 2018) of the Committee
on Finance and Administration. Second Vice-President and
Chair (2019), Vice-Chair (2022) and member (2020–2023)
of the Standing Committee on Estimates.
St. Petersburg Medical Academy of Postgraduate Studies;
Chief Professor and Head of the Department for Medical
Research and Healthy Lifestyles, Herzen State Pedagogical
University of Russia (2000–2008); Professor, Department for
Conflict Studies, Faculty of Philosophy, St. Petersburg State
University (2004–2008).
Member of many associations and societies, including the
Association of Psychiatrists and Drug Addiction Specialists
of the Russian Federation and St. Petersburg, the Kettil
Bruun Society for Social and Epidemiological Research
on Alcohol, the International Council on Alcohol and
Addictions and the International Society of Addiction
Medicine. Head of the sociology of science aspects of
medical and biological research section of the Research
Council on the Sociology of Science and the Organization
of Scientific Research, St. Petersburg Scientific Centre of the
Russian Academy of Sciences (2002–2008).
Author of more than 100 publications, including more than
70 works published in the Russian Federation, chapters in
monographs and several practical guides. Award for excel-
lence in health protection from the Ministry of Health of
the Union of Soviet Socialist Republics (1987). Consultant,
Global Business Coalition on HIV/AIDS, Tuberculosis and
Malaria (since 2006).
Expert on the epidemiology of drug addiction, Pompidou
Group of the Council of Europe (1994–2003); participa-
tion in the WHO cocaine project (1993–1994) as leading
researcher; WHO Healthy Cities project (1992–1998) as
leading coordinator in St. Petersburg; WHO alcohol action
plan, realization on the basis of the city treatment centre,
St. Petersburg (1992–1998). Co-trainer, WHO programmes
“Helping people change” (since 1992) and “Skills for change”
(since 1995); and temporary adviser, WHO (1992–2008).
Participant in meetings of the Commission on Narcotic
Drugs (2002–2008).
Member of INCB (2010–2015 and since 2017). Vice-Chair
(2011, 2012, 2017 and 2019) and member (2018 and 2022–
2023) of the Standing Committee on Estimates. Member of
the Committee on Finance and Administration (2020). First
Vice-President of the Board (2013 and 2021).
Galina Korchagina
Born in 1953. National of the Russian Federation. Professor,
Deputy Director of the National Centre for Research on
Drug Addiction (since 2010).
Graduate of the Leningrad Paediatric Medical Institute,
Russian Federation (1976); Doctor of Medicine (2001).
Thesis based on clinical and epidemiological research deal-
ing with new ways of looking at management of drug abuse
in a time of change.
Previously held positions as paediatrician at the Central
District Hospital of Gatchina, Leningrad region, and doctor
at a boarding school (1976–1979); Head of the Organizational
and Policy Division, Leningrad Regional Drug Clinic (1981–
1989); Lecturer, Leningrad Regional Medical Academy
(1981–1989); Head Doctor, City Drug Clinic, St. Petersburg
(1989–1994); Assistant Lecturer (1991–1996) and Professor
(2000–2001), Department of Social Technologies, State
Institute for Services and Economics; Assistant Lecturer
(1994–2000), Associate Professor (2001–2002) and Professor
(2002–2008), Department for Research on Drug Addiction,
Pierre Lapaque
Born in 1958. National of France. Master’s degree in public
law from the University of Toulon and the Var, France.
Previously held positions of Regional Director of the United
Nations Office on Drugs and Crime (UNODC) for the
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INCB REPORT 2023
Andean Region and the Southern Cone (Argentina, Chile,
Colombia, Ecuador, Paraguay, Peru, Uruguay) (January
2022); UNODC Representative for Colombia (2019–2021);
UNODC Regional Representative for West and Central
Africa, Dakar (2012–2021); Chief, Implementation Support
Section, Organized Crime and Illicit Trafficking Branch,
UNODC, Vienna (2010–2012); Chief, Law Enforcement,
Organized Crime and Anti-Money-Laundering Unit,
UNODC, Vienna (2009–2010); Attaché for Internal Security
at the Embassy of France in Portugal (2005–2009); Senior
adviser, Inter-American Drug Abuse Control Commission,
Organization of American States, Washington, D.C., (2002–
2005); Deputy Director of the Caribbean Financial Action
Task Force (Trinidad and Tobago) (1999–2002); Head of
various operational services in the French criminal inves-
tigation police (ranks ranging from Inspector of Police to
Commissioner General of Police) (1982–1998).
Drafter and contributor to “Le Groupe d’action financière
des Caraïbes (GAFIC)”, in the journal of INTERPOL, 2000.
Spoke on drugs, money-laundering, transnational organ-
ized crime and the financing of terrorism at a number of
international forums (Financial Action Task Force, Group of
Seven under the Presidency of the United Kingdom, Dakar
Forum on organized crime in Africa) (since 1999); presented
the work of UNODC at meetings of the Commission on
Narcotic Drugs and the Commission on Crime Prevention
and Criminal Justice (2009–2022); spoke at meetings of the
OAS Inter-American Drug Abuse Control Commission
(General Assembly and Permanent Council) on develop-
ments related to drugs and the laundering of criminal assets
in the Americas (2002–2005); and presented, as team leader,
13 mutual evaluations by member countries of the Caribbean
Financial Action Task Force (1999–2002). Honours: Order of
San Carlos at the level of Grand Cross (Colombia, June 2022).
Member of International Narcotics Control Board (since
2023).
1
Expert Committee on Drug Dependence; Associate Editor,
Drug and Alcohol Dependence;
Associate Editor,
American
Journal on Addictions.
Doctor of Medicine and Doctor of Philosophy (PhD) in
Psychiatry, West China Medical Center, Sichuan University,
China.
Previously held positions as Research Scientist, National
Institute on Drug Abuse of the National Institutes of Health,
United States (2003–2006); Postdoctoral Fellow, National
Institute on Drug Abuse of the National Institutes of Health
of the United States (2001–2003).
Author of and contributor to numerous publications includ-
ing: “2019-nCoV epidemic: address mental health care to
empower society”,
The Lancet,
vol. 395, No. 10224 (February
2020), pp. 37–38; “Control of fentanyl-related substances
in China”,
The Lancet Psychiatry,
vol. 6, No. 7 (July 2019),
p. 15; “Effect of selective inhibition of reactivated nico-
tine-associated memories with propranolol on nicotine
craving”,
JAMA Psychiatry,
vol. 74, No. 3 (March 2017),
pp. 224–232; “Selective inhibition of amygdala neuronal
ensembles encoding nicotine-associated memories inhibits
nicotine preference and relapse”,
Biological Psychiatry,
vol. 82, No. 11 (December 2017), pp. 781–793; “A novel
UCS memory retrieval-extinction procedure to inhibit
relapse to drug seeking”,
Nature Communications,
vol. 6,
No. 7675 (July 2015); “A memory retrieval-extinction proce-
dure to prevent drug craving and relapse”,
Science,
vol. 336,
No. 6078 (April 2013), pp. 241–245.
Honours include: National Innovation Award (2020);
Academician, Chinese Academy of Sciences (2017); Chinese
Medical Science and Technology Award (2008 and 2015);
Natural Science Award of the Ministry of Education (2008
and 2013); National Natural Science Award (2002).
Member of the International Narcotics Control Board
(since 2022). Member of the Standing Committee on
Estimates (2022). Member of the Committee on Finance
and Administration (2023).
Lu Lin
Born in 1966. National of China. Professor/Director, National
Institute on Drug Dependence, Peking University; Professor/
Director, Peking University Sixth Hospital/Institute of Mental
Health; Professor/Director, National Clinical Research Center
for Mental Disorders, China; Chair, Expert Committee on
Drug Abuse Prevention and Control, National Narcotics
Control Committee, China; Vice-President, Asian Association
for Substance Abuse Research; Committee member, WHO
1
Pavel Pachta
Born in 1953. National of Czechia. Retired Director for
International Regulatory Affairs, International Cannabis
and Cannabinoids Institute (2018–2021).
Master of Science in Foreign Trade (1976), Doctorate in
International Economic Relations (1981), Prague University
of Economics and Business.
Elected by the Economic and Social Council on 25 July 2023.
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Previously held positions of Deputy Secretary of INCB (2004–
2013); Acting Secretary of INCB in 2011; Chief, Narcotics
Control and Estimates Section, Secretariat of INCB, UNODC
(2001–2013); Chief, Psychotropics Control Section, INCB
Secretariat, UNODC (1991–2000); Assistant Professor,
Prague University of Economics and Business (1976–1986).
Member of the Scientific Board of the Prague University of
Economics and Business (2016–2022) and the International
Cannabis and Cannabinoids Institute (2015–2021).
Drafter of and contributor to several publications of INCB,
including sections of INCB annual reports (1991–2012),
INCB technical reports on psychotropic substances (1991–
2000) and INCB technical reports on narcotic drugs (2001–
2012). Contributor on behalf of INCB to the following
WHO publications:
Guidelines for the Psychosocially Assisted
Pharmacological Treatment of Opioid Dependence
(2009),
“Guidance on the WHO review of psychoactive sub-
stances for international control” (2010),
Ensuring Balance
in National Policies on Controlled Substances: Guidance for
Availability and Accessibility of Controlled Medicines
(2011).
Member of INCB delegations at the following meetings:
Commission on Narcotic Drugs, Vienna, several meetings
between 1991–2013; Economic and Social Council, sub-
stantive session, New York in 2004, New York in 2008 and
Geneva in 2011; high-level meeting of the General Assembly
on the prevention and control of non-communicable dis-
eases, New York, 2011; World Health Assembly, Geneva, in
2002, 2003 and 2011; WHO Expert Committee on Drug
Dependence, Geneva, 2006.
Keynote speaker at several international conferences and
lecturer at many training events, such as: Challenges for
Promotion of the Countermeasures against Amphetamine-
type Stimulants Abuse, Tokyo, 2001; Harmonization of Licit
Drug Control Laws in Central Asia, Almaty, 2004; Worldwide
Summit for National Associations of Hospice and Palliative
Care, Vienna, 2009; Medical Cannabis and Cannabinoids,
Prague, 2015; Medical, Scientific and Industrial Use of
Cannabis, Bogotá, 2019; Participant in the INCB expert group
meeting on control and monitoring requirements for can-
nabis and cannabis-related substances, 2021.
Member of International Narcotics Control Board (since
2022).
2
Member of the Standing Committee on Estimates
(2023).
Jagjit Pavadia
Born in 1954. National of India. Graduate in English Honours
(1974), Dhaka University, LLB from Delhi University (1988),
Master’s Diploma in Public Administration, Indian Institute
of Public Administration (1996). Completed dissertation
“Forfeiture of property under the Narcotics Drugs and
Psychotropic Substances Act, 1985” towards completion of
Master’s Diploma.
Held several senior positions in the Indian Revenue Service
for 35 years in the Government of India, including Narcotics
Commissioner of India, Central Bureau of Narcotics
(2006–2012); Commissioner, Legal Affairs (2001–2005);
Chief Vigilance Officer, Power Finance Corporation (1996–
2001); Customs Training Adviser Maldives, deputed by the
Commonwealth Secretariat (1994–1995); Deputy Director,
Narcotics Control Bureau (1990–1994); and retired as Chief
Commissioner, Customs, Central Excise and Service Tax,
Nagpur, in 2014.
Recipient of Presidential Appreciation Certificate for
Specially Distinguished Record of Service on the occasion
of Republic Day (2005), published in the
Gazette of India
Extraordinary.
Member of the Indian delegation to the Commission on
Narcotic Drugs, Vienna (2007–2012); introduced reso-
lutions 51/15 (2008) and 53/12 (2010), adopted by the
Commission on Narcotic Drugs, and organized a side
event on the margins of the Commission’s 2011 session,
presenting issues involved in the illegal movement of opium
poppy seeds to producing, importing and exporting coun-
tries. As representative of the competent national author-
ity, attended Project Prism and Project Cohesion task force
meetings (2006–2012), and coordinated and organized the
Project Prism and Project Cohesion meeting in New Delhi
(2008). Participated in the Thirtieth Meeting of Heads of
National Drug Law Enforcement Agencies, Asia and the
Pacific, held in Bangkok (2006), and organized the Thirty-
fifth Meeting of Heads of National Drug Law Enforcement
Agencies, Asia and the Pacific, held in Agra, India (2011).
Member of the INCB advisory expert group on the sched-
uling of substances (2006), and member of the advisory
group finalizing the INCB
Guidelines for a Voluntary Code of
Practice for the Chemical Industry
(2008). Rapporteur of the
Subcommission on Illicit Drug Traffic and Related Matters
in the Near and Middle East at its forty-first session, held
in Amman (2006); Chair of the Subcommission at its forty-
second session, held in Accra, India (2007); organized the
meeting of the Paris Pact Initiative Expert Working Group
on Precursors, held in New Delhi (2011), and participated
in the International Drug Enforcement Conferences hosted
2
Elected by the Economic and Social Council on 7 December 2022.
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INCB REPORT 2023
by the Drug Enforcement Agency of the United States, held
in Istanbul, Türkiye (2008) and Cancún, Mexico (2011).
Member of INCB (since 2015). Second Vice-President and
Chair (2015, 2017 and 2020), Vice-Chair (2018) and member
(2019 and 2023) of the Standing Committee on Estimates.
Member (2016–2017 and 2020) and Chair (2019 and 2023)
of the Committee on Finance and Administration. First
Vice-President of the Board (2016). President of the Board
(2021–2022).
N. Larissa Razanadimby
Born in 1988. National of Madagascar. Head of the Division
for the importation of products under international con-
trol and customs clearance of donated health products,
Department of Health Products Management, Directorate
of Pharmacy, Laboratories and Traditional Medicine of the
Ministry of Public Health (2014–2021).
Pharmacist, Graduate of the Faculty of Medicine, Specializa-
tion in Pharmacy, University of Antananarivo, Madagascar.
Previously, manager of the medical products storage ware-
house of the Department of Pharmacy, Laboratories and
Traditional Medicine, Ministry of Public Health (2014–
2015); consulting positions in the Biorama cosmetics labora-
tory in Antananarivo, Madagascar (2014), acting pharmacist
at the Ankadifotsy Pharmacy, Antananarivo, Madagascar
(2013).
Appointed Permanent Secretary of the Technical Unit in
Logistics Management of the Ministry of Public Health
(2016).
Member of the Council of the National Order of Pharmacists
of Madagascar, Member of the Board of Directors of the
Solid Solutes Supply Unit in Madagascar (2019), Member of
the Commission for the opening and closing of drug depots
intended for human use of the Ministry of Public Health,
Member of the Logistics Commission of the Ministry of
Public Health of Madagascar, Member of the Drafting
Committee of the National Pharmaceutical Policy and
the National Pharmaceutical Master Plan of Madagascar
(2016).
Lecturer on pharmacology and therapeutics, Nursing
Sciences, Interregional Training Institute for Paramedics.
Consultant for the implementation of the Accredited
Drug Dispensing Outlet project (2022) within USAID,
Madagascar (2022).
Participant in the subregional workshop for the strengthen-
ing of national skills and the improvement of procedures
for the selection of essential medicines, including those
for mothers and children, by experts from WHO, held in
Cotonou, Benin (2018), training on supportive supervision,
by USAID, Antananarivo, Madagascar (2018), training of
quantifier pools on the need for health inputs, by USAID,
Antsirabe, Madagascar (2018), training on supply chain
management by Pamela Steele Associates, Nairobi (2017),
seminar on pharmaceutical investment and cooperation
by the Government of China, Beijing and Shanghai, China
(2017), management training, monitoring and evalua-
tion of the input supply chain, by USAID Deliver Project,
Antananarivo, Madagascar (2016).
Publications include the scientific communication presented
at the Biomad III conference in Mahajanga, Madagascar, on
the theme “Health and biodiversity”.
Member of the International Narcotics Control Board
(since 2022). Member (2022) and Vice-Chair (2023) of the
Standing Committee on Estimates.
Mariângela Simâo
Born in 1956. National of Brazil. Director-President,
Instituto Todos pela Saúde in São Paulo, Brazil, 2023.
Medical Doctor; Diploma in Public Heath; MSc, with
degrees in Paediatrics and Public Health.
Previously held positions as WHO Assistant Director-
General for Access to Medicines and Health Products (2017–
2022); UNAIDS Director of the Community Support, Social
Justice and Inclusion Department (2010–2017); Brazilian
Ministry of Health Director of the HIV/STI/Viral Hepatitis
Department (2005–2010); several managerial posts at state
and municipal levels in Paraná, Brazil (1983–2003).
Author and co-author of numerous papers in scientific
journals, with a focus on primary health care in Brazil,
HIV, stigma and discrimination against vulnerable groups,
improving access to medicines in general and in particular
on palliative care, as well as on public health, drug policy
and harm reduction.
Several high-level meetings including the United Nations
General Assembly, special sessions of the General Assembly
on HIV, Commission on Narcotic Drugs, World Health
Assembly and Executive Board meetings. Currently a
board member of a range of international organizations,
as well as scientific and advisory groups.
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Member of International Narcotics Control Board (since
2023).
3
and member of the Reference Group to the United Nations
on HIV and injecting drug use.
Held consultancy roles with the WHO Regional Office
for the Eastern Mediterranean, UNODC and other inter-
national institutions, research fellowships and the National
Institute on Drug Abuse of the United States. Published
widely in the field of psychiatry, alcohol and drug abuse.
Member of INCB (since 2015). Member of the Standing
Committee on Estimates (2015). Chair (2021) and member
(2016) of the Committee on Finance and Administration.
First Vice-President of the Board (2018). President of the
Board (2023).
Jallal Toufiq
Born in 1963. National of Morocco. Head of the National
Centre for Drug Abuse Prevention and Research; Director
of the Moroccan National Observatory on Drugs and
Addictions; Director of the Ar-razi University Psychiatric
Hospital and Professor of Psychiatry at the Rabat Faculty
of Medicine.
Medical Doctor, Rabat Faculty of Medicine (1989); Diploma
of Specialization in Psychiatry (1994); lecturer at the Rabat
Faculty of Medicine (since 1995). Undertook specialized
training in Paris at the Sainte-Anne Psychiatric Hospital
and Marmottan Centre (1990–1991) and at Johns Hopkins
University as a National Institute on Drug Abuse research
fellow and Clinical Observer (1994–1995). Conducted
research at the University of Pittsburgh (1995); gained clini-
cal drug research certificates at the Vienna School of Clinical
Research (2001 and 2002).
Currently holding positions in Morocco as Head of the
Harm Reduction Programme, National Centre for Drug
Abuse Prevention and Research; teaching and residency
training coordinator, Ar-razi Hospital; Director of the
National Diploma Programme on Treatment and Prevention
of Drug Abuse, Rabat Faculty of Medicine; Director of the
National Diploma Programme on Child Psychiatry, Rabat
Faculty of Medicine, and member of the Ministry of Health
Commission on Drug Abuse.
At the international level, Representative of the
Mediterranean Network (MedNET) for Morocco (MedNET/
Pompidou Group/Council of Europe); former perma-
nent correspondent of the Pompidou Group for Morocco
(Council of Europe) on drug abuse prevention and research
and former member of the Reference Group to the United
Nations on HIV and Injecting Drug Use. Founding member
and steering committee member, Middle East and North
Africa Harm Reduction Association (MENAHRA); Director
of Knowledge Hub Ar-razi for North Africa, MENAHRA;
member, Mentor International Scientific Advisory Network
(drug abuse prevention in youth); former focal point/
expert on prevention, United Nations Office on Drug
Control and Crime Prevention (local network for North
Africa); founding member, MedNET (advisory group on
AIDS and drug abuse policies) of the Council of Europe,
Zukiswa Zingela
Born in 1969. National of South Africa. Associate Professor
and Executive Dean, Faculty of Health Sciences, Nelson
Mandela University (since 2021).
Master of Medicine, Psychiatry (University of Pretoria);
Fellow of the College of Psychiatrists of South Africa, PhD,
Psychology (Nelson Mandela University).
Serves on the Medical and Dental Board of the Health
Professions Council of South Africa and is also the
Chairperson of the Health Committee of the Medical and
Dental Board.
Previously held positions as Head, Department of Psychiatry
and Behavioural Sciences, Walter Sisulu University
and Nelson Mandela Academic Hospital, Eastern Cape
Department of Health (2015–2021); Leader of the Dean’s
Advisory Committee in charge of the Faculty of Health
Sciences, Walter Sisulu University (2016–2017); Head
of Clinical Unit, Dora Nginza Hospital, Eastern Cape
Department of Health, and Senior Lecturer at Walter Sisulu
University (2011–2015); Specialist Psychiatrist in private
practice (2003–2008); Consultant Psychiatrist, Blackpool
North Community Mental Health Team, National Health
Service, United Kingdom of Great Britain and Northern
Ireland (2003–2008). Duties in the above-mentioned posts
included training of undergraduate medical students and
postgraduate students in psychiatry with an emphasis on
addiction psychiatry and substance use, providing substitu-
tion treatment for patients with opioid use-related disorders,
neuropsychiatry, consultation liaison psychiatry, child and
adolescent psychiatry, old age psychiatry, psychopharma-
cology and public mental health. Honours: Chairperson
of the Board of the Ernest Malgas Youth Treatment
Centre (Rehabilitation for Substance Abuse) (2016–2018);
3
Elected by the Economic and Social Council on 25 July 2023.
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INCB REPORT 2023
Chairperson of the South African Society of Psychiatrists,
Eastern Cape Subgroup (2016–2018); Chairperson of Walter
Sisulu University Registrar Training and Implementation
Committee (2015–2018); Chairperson of Task Team
appointed by the Head of Department of the Eastern Cape
Department of Health to investigate allegations of patient
abuse in Tower Psychiatric Hospital and Rehabilitation
Centre, with the investigative report delivered to Minister
of Health in 2018.
Author and co-author of numerous publications includ-
ing “First-episode psychosis and substance use” (authors:
Thungana and Zingela (supervisor) and van Wyk (co-
supervisor)),
South African Journal of Psychiatry,
vol. 24
(2018); “Personality and personality disorder” (co-authors:
Nagdee, Grobler and Zingela), chapter in
Oxford Textbook
of Psychiatry for Southern Africa
(J. Burns and L. Roos, eds.),
2nd ed., 2016).
Member of steering committee for establishment of rehabili-
tation for substance abuse (Ernest Malgas Youth Treatment
Centre) (2012–2015); consultant, consultation committee
on the implementation of the Prevention of and Treatment
of Substance Abuse Act. Advised, on a voluntary basis, the
Ernest Malgas Youth Treatment Centre on implementation
of substance abuse act and support for starting the rehabili-
tation programme (2015); established a mental health out-
reach programme for the Ernest Malgas Youth Treatment
Centre offering assessment and interventions (since 2016);
facilitated support from the Department of Health to the
local drug action committee through the allocation of a
multidisciplinary staff member (clinical psychologist) to
serve on the committee (2014–2016).
Fifteenth Biannual National Congress of the South African
Society of Psychiatrists, 2018 (presented paper on first epi-
sode psychosis and substance abuse (authors: Thungana,
Zingela and van Wyk)); substance abuse assessment and
intervention: provincial training organized by Walter Sisulu
University and Eastern Cape Department of Health, 2017;
Seventh African Population Conference, Johannesburg,
South Africa, 2015 (presented paper on school-based sub-
stance abuse awareness programmes, (authors: Zingela,
Bronkhorst and Ngwetsheni); and paper on the integration
of the South African Master Drug Plan Policy and Mental
Health Policy Framework and Strategic Plan (author:
Zingela); National Substance Abuse Colloquium, 2015
(chaired and presented paper on aftercare, outpatient and
maintenance services for substance abuse); Substance Abuse
Colloquium, Port Elizabeth, South Africa, in preparation for
the opening of the Ernest Malgas Youth Treatment Centre,
2015 (organizer).
Member of INCB (since 2020). Second Vice-President and
Chair (2023), Vice-Chair (2021) and member (2020) of the
Standing Committee on Estimates. First Vice-President of
the Board (2022).
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About the International Narcotics
Control Board
INCB is an independent and quasi-judicial control organ,
established by treaty, for monitoring the implementation of
the international drug control treaties. It had predecessors
under the former drug control treaties as far back as the time
of the League of Nations.
the illicit manufacture of drugs and assists them in prevent-
ing the diversion of those chemicals into the illicit traffic;
(b)
As regards the illicit manufacture of, trafficking in and
use of drugs, INCB identifies weaknesses in national and
international control systems and contributes to correct-
ing such situations. INCB is also responsible for assessing
chemicals used in the illicit manufacture of drugs, in order
to determine whether they should be placed under inter-
national control.
In the discharge of its responsibilities, INCB:
(a)
Administers a system of estimates for narcotic
drugs and a voluntary assessment system for psychotropic
substances and monitors licit activities involving drugs
through a statistical returns system, with a view to assist-
ing Governments in achieving, inter alia, a balance between
supply and demand;
(b)
Monitors and promotes measures taken by
Governments to prevent the diversion of substances fre-
quently used in the illicit manufacture of narcotic drugs
and psychotropic substances and assesses such substances to
determine whether there is a need for changes in the scope
of control of Tables I and II of the 1988 Convention;
(c)
Analyses information provided by Governments,
United Nations bodies, specialized agencies or other com-
petent international organizations, with a view to ensuring
that the provisions of the international drug control trea-
ties are adequately carried out by Governments, and recom-
mends remedial measures;
(d)
Maintains a permanent dialogue with Governments
to assist them in complying with their obligations under the
international drug control treaties and, to that end, recom-
mends, where appropriate, technical or financial assistance
to be provided.
INCB is called upon to ask for explanations in the event
of apparent violations of the treaties, to propose appropri-
ate remedial measures to Governments that are not fully
applying the provisions of the treaties or are encountering
difficulties in applying them and, where necessary, to assist
Governments in overcoming such difficulties. If, however,
INCB notes that the measures necessary to remedy a seri-
ous situation have not been taken, it may call the matter to
the attention of the parties concerned, the Commission
on Narcotic Drugs and the Economic and Social Council.
As a last resort, the treaties empower INCB to recommend
to parties that they stop importing drugs from a defaulting
country, exporting drugs to it or both. In all cases, INCB
acts in close cooperation with Governments.
Composition
INCB consists of 13 members who are elected by the
Economic and Social Council and who serve in their per-
sonal capacity, not as government representatives.
Three members with medical, pharmacological or pharma-
ceutical experience are elected from a list of persons nomi-
nated by WHO and 10 members are elected from a list of
persons nominated by Governments. Members of the Board
are persons who, by their competence, impartiality and dis-
interestedness, command general confidence. The Council,
in consultation with INCB, makes all arrangements neces-
sary to ensure the full technical independence of the Board
in carrying out its functions. INCB has a secretariat that
assists it in the exercise of its treaty-related functions. The
INCB secretariat is an administrative entity of UNODC,
but it reports solely to the Board on matters of substance.
INCB closely collaborates with UNODC in the framework
of arrangements approved by the Council in its resolution
1991/48. INCB also cooperates with other international
bodies concerned with drug control, including not only
the Council and its Commission on Narcotic Drugs, but
also the relevant specialized agencies of the United Nations,
particularly WHO. It also cooperates with bodies outside the
United Nations system, especially INTERPOL and WCO.
Functions
The functions of INCB are laid down in the following
treaties: Single Convention on Narcotic Drugs of 1961 as
amended by the 1972 Protocol; Convention on Psychotropic
Substances of 1971; and United Nations Convention against
Illicit Traffic in Narcotic Drugs and Psychotropic Substances
of 1988. Broadly speaking, INCB deals with the following:
(a)
As regards the licit manufacture of, trade in and use of
drugs, INCB endeavours, in cooperation with Governments,
to ensure that adequate supplies of drugs are available for
medical and scientific uses and that the diversion of drugs
from licit sources to illicit channels does not occur. INCB
also monitors Governments’ control over chemicals used in
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INCB assists national administrations in meeting their obli-
gations under the conventions. To that end, it proposes and
participates in regional training seminars and programmes
for drug control administrators.
1992:
1993:
1994:
1995:
1996:
1997:
1998:
1999:
2000:
2001:
Legalization of the non-medical use of drugs
The importance of demand reduction
Evaluation of the effectiveness of the
international drug control treaties
Giving more priority to combating
money-laundering
Drug abuse and the criminal justice system
Preventing drug abuse in an environment of
illicit drug promotion
International control of drugs: past, present
and future
Freedom from pain and suffering
Overconsumption of internationally
controlled drugs
Globalization and new technologies:
challenges to drug law enforcement in the
twenty-first century
Illicit drugs and economic development
Drugs, crime and violence: the micro-level
impact
Integration of supply and demand reduction
strategies: moving beyond a balanced
approach
Alternative development and legitimate
livelihoods
Internationally controlled drugs and the
unregulated market
The principle of proportionality and drug-
related offences
The international drug control conventions:
history, achievements and challenges
Primary prevention of drug abuse
Drugs and corruption
Social cohesion, social disorganization and
illegal drugs
Shared responsibility in international drug
control
Economic consequences of drug abuse
Implementation of a comprehensive,
integrated and balanced approach to
addressing the world drug problem
The health and welfare of mankind:
challenges and opportunities for the
international control of drugs
Reports
The international drug control treaties require INCB to
prepare an annual report on its work. The annual report
contains an analysis of the drug control situation worldwide
so that Governments are kept aware of existing and potential
situations that may endanger the objectives of the inter-
national drug control treaties. INCB draws the attention of
Governments to gaps and weaknesses in national control
and in treaty compliance; it also makes suggestions and rec-
ommendations for improvements at both the national and
international levels. The annual report is based on informa-
tion provided by Governments to INCB, United Nations
entities and other organizations. It also uses information
provided through other international organizations, such
as INTERPOL and WCO, as well as regional organizations.
The annual report of INCB is supplemented by detailed
technical reports. They contain data on the licit movement
of narcotic drugs and psychotropic substances required for
medical and scientific purposes, together with an analysis of
those data by INCB. Those data are required for the proper
functioning of the system of control over the licit movement
of narcotic drugs and psychotropic substances, including
preventing their diversion to illicit channels. Moreover,
under the provisions of article 12 of the 1988 Convention,
INCB reports annually to the Commission on Narcotic
Drugs on the implementation of that article. That report,
which gives an account of the results of the monitoring of
precursors and of the chemicals frequently used in the illicit
manufacture of narcotic drugs and psychotropic substances,
is also published as a supplement to the annual report.
Since 1992, the first chapter of the annual report has been
devoted to a specific drug control issue on which INCB
presents its conclusions and recommendations in order to
contribute to policy-related discussions and decisions in
national, regional and international drug control. The fol-
lowing topics were covered in past annual reports:
2002:
2003:
2004:
2005:
2006:
2007:
2008:
2009:
2010:
2011:
2012:
2013:
2014:
2015:
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2016:
2017:
Women and drugs
Treatment, rehabilitation and social
reintegration for drug use disorders: essential
components of drug demand reduction
Cannabis and cannabinoids for medical,
scientific and “recreational” use: risks and
benefits
Improving substance use prevention and
treatment services for young people
A hidden epidemic: the use of drugs among
older persons
Illicit financial flows related to drug
trafficking and their impact on development
and security
Analysis of the trend to legalize the non-
medical use of cannabis
Chapter I of the report of the Board for 2023 is entitled
“The role of the Internet, including social media, in drug
trafficking and use”.
Chapter II presents an analysis of the operation of the inter-
national drug control system based primarily on informa-
tion that Governments are required to submit directly to
INCB in accordance with the international drug control
treaties. Its focus is on the worldwide control of all licit
activities related to narcotic drugs and psychotropic sub-
stances, as well as chemicals used in the illicit manufacture
of such drugs.
Chapter III presents global issues and some of the major
developments in drug abuse and trafficking and measures
by Governments to implement the international drug con-
trol treaties by addressing those problems.
Chapter IV presents the main recommendations addressed
by INCB to Governments, UNODC, WHO and other rele-
vant international and regional organizations.
2018:
2019:
2020:
2021:
2022:
 REU, Alm.del - 2023-24 - Endeligt svar på spørgsmål 744: Spm. om redegørelse for den indførte ordning ift. cannabis i Tyskland i relation til FN`s narkotikakonvention og EU-retlige regler REU, Alm.del - 2023-24 - Endeligt svar på spørgsmål 744: Spm. om redegørelse for den indførte ordning ift. cannabis i Tyskland i relation til FN`s narkotikakonvention og EU-retlige regler
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United Nations system and drug control organs and their secretariat
General Assembly
Economic and Social
Council
INCB
Commission on
Narcotic Drugs
UNODC/INCB secretariat
a
Key:
Direct connection (administrative or constitutional)
Reporting, cooperating and advising relationship
a
The INCB secretariat reports on substantive matters to INCB only.
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INTERNATIONAL NARCOTICS CONTROL BOARD
The International Narcotics Control Board (INCB) is the independent monitoring body for the
implementation of United Nations international drug control conventions. It was established in
1968 in accordance with the Single Convention on Narcotic Drugs, 1961. It had predecessors
under the former drug control treaties as far back as the time of the League of Nations.
Based on its activities, INCB publishes an annual report that is submitted to the United Nations
Economic and Social Council through the Commission on Narcotic Drugs. The report provides a
comprehensive survey of the drug control situation in various parts of the world. As an impartial
body, INCB tries to identify and predict dangerous trends and suggests necessary measures to
be taken.
ISBN 978-92-1-003052-6
2325540